122 results on '"Comorbiditat"'
Search Results
2. Optimization of Patient Pathway in Heart Failure with Reduced Ejection Fraction and Worsening Heart Failure. Role of Vericiguat
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José Ramón González-Juanatey, Josep Comín-Colet, Domingo Pascual Figal, Antoni Bayes-Genis, Jose Maria Cepeda, José M García-Pinilla, Antonio García-Quintana, Luis Manzano, and Jose Luis Zamorano
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Comorbiditat ,Health Policy ,Medicine (miscellaneous) ,Heart failure ,Insuficiència cardíaca ,Comorbidity ,Pharmacology, Toxicology and Pharmaceutics (miscellaneous) ,Social Sciences (miscellaneous) - Abstract
Heart failure (HF) is a progressive condition with periods of apparent stability and repeated worsening HF events. Over time, unless optimization of HF treatment, worsening HF events become more frequent and patients enter into a cycle of recurrent events with high morbidity and mortality. In patients with HF there is an activation of deleterious neurohormonal pathways, such as the renin angiotensin aldosterone system and the sympathetic system, and an inhibition of protective pathways, including natriuretic peptides and guanylate cyclase. Therefore, HF burden can be reduced only through a holistic approach that targets all neurohormonal systems. In this context, vericiguat may play a key role, as it is the only HF drug that activates the nitric oxide-soluble guanylate cyclase-cyclic guanosine monophosphate system. On the other hand, it has been described relevant disparities in the management of HF population. Consequently, it is necessary to homogenize the management of these patients, through an integrated patient-care pathway that should be adapted at the local level. In this context, the development of new technologies (ie, video call, specific platforms, remote control devices, etc.) may be very helpful. In this manuscript, a multidisciplinary group of experts analyzed the current evidence and shared their own experience to provide some recommendations about the therapeutic optimization of patients with recent worsening HF, with a particular focus on vericiguat, and also about how the integrated patient-care pathway should be performed.
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- 2023
3. The role of food addiction and lifetime substance use on eating disorder treatment outcomes
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Miranda-Olivos, Romina, Agüera, Zaida, Granero, Roser, Jiménez-Murcia, Susana, Puig-Llobet, Montserrat, Lluch-Canut, Maria Teresa, Gearhardt, Ashley N., and Fernández-Aranda, Fernando
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Compulsive behavior ,Comorbiditat ,Eating disorders ,Treatment outcomes ,Comorbidity ,Substance use ,Food addiction ,Conducta compulsiva ,Trastorns de la conducta alimentària - Abstract
Altres ajuts: Delegación del Gobierno para el Plan Nacional sobre Drogas (2021I031) Food addiction (FA) and substance use (SU) in eating disorders (ED) have been associated with a more dysfunctional clinical and psychopathological profile. However, their impact on treatment outcomes has been poorly explored. Therefore, this transdiagnostic study is aimed at examining whether the presence of FA and/or SU is associated with treatment outcomes in patients with different ED types. The results were not able to reveal significant differences in treatment outcomes between patients with and without FA and/or SU; however, the effect sizes suggest higher dropout rates in the group with both FA and SU. The predictive models of treatment outcomes showed different features associated with each group. High persistence (i.e., tendency to perseverance and inflexibility) was the personality trait most associated with poor treatment outcomes in patients without addictions. High harm avoidance and younger age at ED onset were the variables most related to poor outcomes in patients with FA or SU. Finally, in the group with both addictive behaviors (FA and SU), the younger patients presented the poorest outcomes. In conclusion, our results suggest that, regardless of presenting addictive behaviors, patients with ED may similarly benefit from treatment. However, it may be important to consider the differential predictors of each group that might guide certain treatment targets.
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- 2023
4. Impact of comorbidities on hospital mortality in patients with acute pancreatitis: a population-based study of 110,021 patients
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Nils Jimmy Hidalgo, Elizabeth Pando, Rodrigo Mata, Nair Fernandes, Sara Villasante, Marta Barros, Daniel Herms, Laia Blanco, Joaquim Balsells, Ramon Charco, Institut Català de la Salut, [Hidalgo NJ, Pando E] Universitat Autònoma de Barcelona, Bellaterra, Spain. Servei de Cirurgia Hepatobiliopancreàtica i Trasplantaments, Vall d’Hebron Hospital Universitari, Barcelona, Spain. [Mata R, Fernandes N, Villasante S, Barros M, Herms D, Blanco L, Balsells J, Charco R] Servei de Cirurgia Hepatobiliopancreàtica i Trasplantaments, Vall d’Hebron Hospital Universitari, Barcelona, Spain, and Vall d'Hebron Barcelona Hospital Campus
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enfermedades del sistema digestivo::enfermedades pancreáticas::pancreatitis [ENFERMEDADES] ,Pancreatitis - Mortalitat ,Otros calificadores::Otros calificadores::Otros calificadores::/mortalidad [Otros calificadores] ,Comorbiditat ,epidemiología y bioestadística::epidemiología::proceso salud-enfermedad::comorbilidad [SALUD PÚBLICA] ,Digestive System Diseases::Pancreatic Diseases::Pancreatitis [DISEASES] ,Other subheadings::Other subheadings::Other subheadings::/mortality [Other subheadings] ,Gastroenterology ,General Medicine ,Epidemiology and Biostatistics::Epidemiology::Health-Disease Process::Comorbidity [PUBLIC HEALTH] - Abstract
Acute pancreatitis; Comorbidity; Hospital mortality Pancreatitis aguda; Comorbilidad; Mortalidad hospitalaria Pancreatitis aguda; Comorbilitat; Mortalitat hospitalària Background The impact of pre-existing comorbidities on acute pancreatitis (AP) mortality is not clearly defined. Our study aims to determine the trend in AP hospital mortality and the role of comorbidities as a predictor of hospital mortality. Methods We analyzed patients aged ≥ 18 years hospitalized with AP diagnosis between 2016 and 2019. The data have been extracted from the Spanish National Hospital Discharge Database of the Spanish Ministry of Health. We performed a univariate and multivariable analysis of the association of age, sex, and comorbidities with hospital mortality in patients with AP. The role of the Charlson and Elixhauser comorbidity indices as predictors of mortality was evaluated. Results A total of 110,021 patients diagnosed with AP were hospitalized during the analyzed period. Hospital mortality was 3.8%, with a progressive decrease observed in the years evaluated. In multivariable analysis, age ≥ 65 years (OR: 4.11, p 1.5 (OR: 2.03, p 1.5 (OR: 2.71, p
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- 2023
5. Comorbidity between lung cancer and COVID-19 pneumonia: role of immunoregulatory gene transcripts in high ACE2-expressing normal lung
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Vladimir Lazar, Jacques Raynaud, Shai Magidi, Catherine Bresson, Jean-François Martini, Susan Galbraith, Fanny Wunder, Amir Onn, Gerald Batist, Nicolas Girard, Ulrik Lassen, C. S. Pramesh, Amal Al-Omari, Sadakatsu Ikeda, Guy Berchem, Jean-Yves Blay, Benjamin Solomon, Enriqueta Felip, Josep Tabernero, Eitan Rubin, Thierry Philip, Angel Porgador, Ioana Berindan-Neagoe, Richard L. Schilsky, Razelle Kurzrock, Institut Català de la Salut, [Lazar V, Raynaud J, Magidi S, Bresson C] Worldwide Innovative Network (WIN) Association – WIN Consortium, Villejuif, France. [Martini JF] Pfizer Inc., San Diego, CA, USA. [Galbraith S] AstraZeneca, Gaithersburg, MD, USA. [Felip E] Vall d’Hebron Hospital Universitari, Barcelona, Spain. Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain. UVic-UCC, Barcelona, Spain, and Vall d'Hebron Barcelona Hospital Campus
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fenómenos genéticos::expresión génica::transcripción genética [FENÓMENOS Y PROCESOS] ,ACE2 expression ,COVID-19 ,Virus Diseases::RNA Virus Infections::Nidovirales Infections::Coronaviridae Infections::Coronavirus Infections [DISEASES] ,Neoplasms::Neoplasms by Site::Thoracic Neoplasms::Respiratory Tract Neoplasms::Lung Neoplasms::Bronchial Neoplasms::Carcinoma, Bronchogenic::Carcinoma, Non-Small-Cell Lung [DISEASES] ,neoplasias::neoplasias por localización::neoplasias torácicas::neoplasias del tracto respiratorio::neoplasias pulmonares::neoplasias de los bronquios::carcinoma broncogénico::carcinoma de pulmón de células no pequeñas [ENFERMEDADES] ,COVID-19 (Malaltia) ,transcriptomics ,Transcripció genètica ,Oncology ,Comorbiditat ,Pulmons - Càncer ,epidemiología y bioestadística::epidemiología::proceso salud-enfermedad::comorbilidad [SALUD PÚBLICA] ,virosis::infecciones por virus ARN::infecciones por Nidovirales::infecciones por Coronaviridae::infecciones por Coronavirus [ENFERMEDADES] ,cancer ,normal lung ,Genetic Phenomena::Gene Expression::Transcription, Genetic [PHENOMENA AND PROCESSES] ,Epidemiology and Biostatistics::Epidemiology::Health-Disease Process::Comorbidity [PUBLIC HEALTH] - Abstract
ACE2 expression; COVID-19; Cancer Expresión ACE2; COVID-19; Cáncer Expressió ACE2; COVID-19; Càncer Background: SARS-CoV-2 (COVID-19) elicits a T-cell antigen-mediated immune response of variable efficacy. To understand this variability, we explored transcriptomic expression of angiotensin-converting enzyme 2 (ACE2, the SARS-CoV-2 receptor) and of immunoregulatory genes in normal lung tissues from patients with non-small cell lung cancer (NSCLC). Methods: This study used the transcriptomic and the clinical data for NSCLC patients generated during the CHEMORES study [n = 123 primary resected (early-stage) NSCLC] and the WINTHER clinical trial (n = 32 metastatic NSCLC). Results: We identified patient subgroups with high and low ACE2 expression (p = 1.55 × 10−19) in normal lung tissue, presumed to be at higher and lower risk, respectively, of developing severe COVID-19 should they become infected. ACE2 transcript expression in normal lung tissues (but not in tumor tissue) of patients with NSCLC was higher in individuals with more advanced disease. High-ACE2 expressors had significantly higher levels of CD8+ cytotoxic T lymphocytes and natural killer cells but with presumably impaired function by high Thymocyte Selection-Associated High Mobility Group Box Protein TOX (TOX) expression. In addition, immune checkpoint-related molecules – PD-L1, CTLA-4, PD-1, and TIGIT – are more highly expressed in normal (but not tumor) lung tissues; these molecules might dampen immune response to either viruses or cancer. Importantly, however, high inducible T-cell co-stimulator (ICOS), which can amplify immune and cytokine reactivity, significantly correlated with high ACE2 expression in univariable analysis of normal lung (but not lung tumor tissue). Conclusions: We report a normal lung immune-tolerant state that may explain a potential comorbidity risk between two diseases – NSCLC and susceptibility to COVID-19 pneumonia. Further, a NSCLC patient subgroup has normal lung tissue expressing high ACE2 and high ICOS transcripts, the latter potentially promoting a hyperimmune response, and possibly leading to severe COVID-19 pulmonary compromise. FundingThe authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: The research leading to these results on the CHEMORES study data, an initiative from the Chemotherapy resistance consortium, has received funding from the European Union Sixth Framework (FP6) Integrated Project. The research on the WINTHER trial data leading to these results has received funding from the European Union Seventh Framework Program (FP7) (WINTHER: FP7/2007-2013 under grant agreement n°306125). WINTHER, an initiative from the WIN Consortium, was funded in part by ARC Foundation for cancer research (France), Pfizer Oncology, Lilly France SAS, and Novartis Pharmaceuticals Corporation. Funded in part by The FERO/J.P. Morgan Private Bank Clinical Oncology Research Grant, National Cancer Institute grant P30 P30-CA023100 (RK), Israeli Science Foundation grant 1188/16 (ER), Instituto Salud Carlos III – Programa Rio Hortega Contract grant CM15/00255 (EF) and Canadian Institutes for Health Research (grant MOP-142281, GB) and the Canadian Cancer Society (grant 703811, GB).
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- 2022
6. New Perspectives on Chronic Obstructive Pulmonary Disease
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Bartolome R, Celli, Dave, Singh, Claus, Vogelmeier, and Alvar, Agusti
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Pulmonary Disease, Chronic Obstructive ,Comorbiditat ,Administration, Inhalation ,Humans ,Muscarinic Antagonists ,General Medicine ,Comorbidity ,International Journal of Chronic Obstructive Pulmonary Disease ,Chronic obstructive pulmonary diseases ,Adrenergic beta-2 Receptor Agonists ,Malalties pulmonars obstructives cròniques ,Bronchodilator Agents - Abstract
Bartolome R Celli,1 Dave Singh,2 Claus Vogelmeier,3 Alvar Agusti4 1School of Medicine, Harvard University, Boston, MA, USA; 2Division of Infection, Immunity & Respiratory Medicine, University of Manchester, Manchester University NHS Hospital Trust, Manchester, UK; 3Department of Medicine, Pulmonary and Critical Care Medicine, German Center for Lung Research (DZL), University of Marburg, Marburg, Germany; 4Respiratory Institute, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERES, Barcelona, SpainCorrespondence: Bartolome R Celli, School of Medicine, Harvard University, 25 Shattuck St, Boston, MA, USA, 02115, Tel +1-617-678-0177, Email bcelli@copdnet.orgAbstract: Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality worldwide; many recent advances have been made in many aspects of the disease. The aim of this article is to illustrate and discuss some of these advances in the management of different types of patients. Large-scale trials have confirmed that long-acting bronchodilator therapy, particularly using the combination of LABA/LAMA, remains the mainstay of COPD treatment, with special attention being paid to careful selection of inhaler devices. The initial choice of pharmacological therapy is based on the GOLD ABCD grouping of patients. It is very important to stress that there is a need to implement a management cycle because COPD is a chronic disease with varying clinical course and a high number of potential comorbidities that may affect morbidity and mortality. Therefore, regular reevaluation of the patient is mandatory. This allows identification of characteristics aimed at maximizing the benefits for a specific patient or a subset of patients. Within this context, the role of the blood eosinophil count as a marker of inhaled corticosteroids response to prevent future exacerbations in patients who, despite appropriate bronchodilator therapy, still suffer from them has been proven to be a useful simple biomarker in medication selection. These advances support the concept of precision medicine, with the goal that patients get the right medicine at the right time for the right reason. Finally, recent studies have shown that early life events may be of critical relevance for the development of COPD. With this as a background, concepts to identify individuals at risk and early identification of cases have become an important objective of current research with the hope of maximizing the effects of therapy and the possibility of impacting disease progression.Keywords: COPD, ABCD grouping, management cycle, eosinophil, LABA/LAMA
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- 2022
7. Prevalence and Impact of Comorbidities in Individuals with Chronic Obstructive Pulmonary Disease: A Systematic Review
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Natasha Cordeiro dos Santos, Marc Miravitlles, Aquiles Assunção Camelier, Victor Durier Cavalcanti de Almeida, Roberto Rodrigues Bandeira Tosta Maciel, Fernanda Warken Rosa Camelier, Institut Català de la Salut, [Santos NCD, Camelier AA, Almeida VDC, Maciel RRBT, Camelier FWR] Department of Life Sciences, State University of Bahia (UNEB), Bahia, Brazil. [Miravitlles M] Servei de Pneumologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Vall d’Hebron Institut de Recerca (VHIR), Barcelona, Spain, and Vall d'Hebron Barcelona Hospital Campus
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Pulmonary and Respiratory Medicine ,Pulmons - Malalties obstructives - Complicacions ,Otros calificadores::Otros calificadores::/complicaciones [Otros calificadores] ,Infectious Diseases ,Comorbiditat ,Respiratory Tract Diseases::Lung Diseases::Lung Diseases, Obstructive::Pulmonary Disease, Chronic Obstructive [DISEASES] ,calidad, acceso y evaluación de la atención sanitaria::calidad de la atención sanitaria::factores epidemiológicos::comorbilidad [ATENCIÓN DE SALUD] ,Hipertensió ,Cardiovascular Diseases::Vascular Diseases::Hypertension [DISEASES] ,Health Care Quality, Access, and Evaluation::Quality of Health Care::Epidemiologic Factors::Comorbidity [HEALTH CARE] ,enfermedades cardiovasculares::enfermedades vasculares::hipertensión [ENFERMEDADES] ,Other subheadings::Other subheadings::/complications [Other subheadings] ,enfermedades respiratorias::enfermedades pulmonares::enfermedades pulmonares obstructivas::enfermedad pulmonar obstructiva crónica [ENFERMEDADES] - Abstract
COPD; Comorbidity; Mortality EPOC; comorbilidad; Mortalidad MPOC; Comorbilitat; Mortalitat This study aimed to describe the prevalence of comorbidities associated with chronic obstructive pulmonary disease (COPD) and their relation with relevant outcomes. A systematic review based on the PRISMA methodology was performed from January 2020 until July 2021. The MEDLINE, Lilacs, and Scielo databases were searched to identify studies related to COPD and its comorbidities. Observational studies on the prevalence of comorbidities in COPD patients and costs with health estimates, reduced quality of life, and mortality were included. Studies that were restricted to one or more COPD pain assessments and only specific comorbidities such as osteoporosis, bronchitis, and asthma were excluded. The initial search identified 1,409 studies and after applying the inclusion and exclusion criteria, 20 studies were finally selected for analysis (comprising data from 447,459 COPD subjects). The most frequent COPD comorbidities were: hypertension (range, 17%-64.7%), coronary artery disease (19.9%-47.8%), diabetes (10.2%-45%), osteoarthritis (18%-43.8%), psychiatric conditions (12.1%-33%), and asthma (14.7%-32.5%). Several comorbidities had an impact on the frequency and severity of COPD exacerbations, quality of life, and mortality risk, in particular malignancies, coronary artery disease, chronic heart failure, and cardiac arrhythmias. Comorbidities, especially cardiovascular diseases and diabetes, are frequent in COPD patients, and some of them are associated with higher mortality. University of Bahia
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- 2022
8. C-Reactive Protein and Serum Albumin Ratio: A Feasible Prognostic Marker in Hospitalized Patients with COVID-19
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Giner Galvañ, Vicente, Pomares Gómez, Francisco, Quesada, José, Rubio Rivas, Manuel, Tejada Montes, Javier, Baltasar Corral, Jesús, Taboada-Martínez, María Luisa, Sánchez Mesa, Blanca, Arnalich Fernández, Francisco, Corral Beamonte, Esther del, López Sampalo, Almudena, Pesqueira Fontán, Paula, Fernández Garcés, Mar, Gómez Huelgas, Ricardo, Ramos Rincón, José, and SEMI-COVID-19 Network
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COVID-19 ,serum albumin ,C-reactive protein ,prognosis ,syndemic ,comorbidity ,Comorbiditat ,Medicine (miscellaneous) ,Comorbidity ,General Biochemistry, Genetics and Molecular Biology - Abstract
(1) Background: C-reactive protein (CRP) and albumin are inflammatory markers. We analyzed the prognostic capacity of serum albumin (SA) and CRP for an outcome comprising mortality, length of stay, ICU admission, and non-invasive mechanical ventilation in hospitalized COVID-19 patients. (2) Methods: We conducted a retrospective cohort study based on the Spanish national SEMI-COVID-19 Registry. Two multivariate logistic models were adjusted for SA, CRP, and their combination. Training and testing samples were used to validate the models. (3) Results: The outcome was present in 41.1% of the 3471 participants, who had lower SA (mean [SD], 3.5 [0.6] g/dL vs. 3.8 [0.5] g/dL; p < 0.001) and higher CRP (108.9 [96.5] mg/L vs. 70.6 [70.3] mg/L; p < 0.001). In the adjusted multivariate model, both were associated with poorer evolution: SA, OR 0.674 (95% CI, 0.551–0.826; p < 0.001); CRP, OR 1.002 (95% CI, 1.001–1.004; p = 0.003). The CRP/SA model had a similar predictive capacity (honest AUC, 0.8135 [0.7865–0.8405]), with a continuously increasing risk and cutoff value of 25 showing the highest predictive capacity (OR, 1.470; 95% CI, 1.188–1.819; p < 0.001). (4) Conclusions: SA and CRP are good independent predictors of patients hospitalized with COVID-19. For the CRP/SA ratio value, 25 is the cutoff for poor clinical course.
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- 2022
9. Informe sobre l’indicador de morbiditat: notificació de nous casos d'infecció pel VIH; any 2021
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Departament de Salut
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Catalonia ,Comorbiditat ,virosis::infecciones por virus ARN::infecciones por Retroviridae::infecciones por Lentivirus::infecciones por VIH [ENFERMEDADES] ,calidad, acceso y evaluación de la atención sanitaria::calidad de la atención sanitaria::factores epidemiológicos::comorbilidad [ATENCIÓN DE SALUD] ,Cataluña ,ambiente y salud pública::salud pública::ambiente y salud pública::salud pública::práctica de la salud pública::control de enfermedades transmisibles::notificación de enfermedades [ATENCIÓN DE SALUD] ,Virus Diseases::RNA Virus Infections::Retroviridae Infections::Lentivirus Infections::HIV Infections [DISEASES] ,Health Care Quality, Access, and Evaluation::Quality of Health Care::Epidemiologic Factors::Comorbidity [HEALTH CARE] ,Infeccions per VIH - Notificació - Catalunya ,Environment and Public Health::Public Health::Environment and Public Health::Public Health::Public Health Practice::Communicable Disease Control::Disease Notification [HEALTH CARE] - Abstract
Notificació; VIH; Virus de la immunodeficiència humana; Infecció Notificación; VIH; Virus de la inmunodeficiencia humana; Infección Notification; HIV; Infection L’objectiu d’aquest Informe és conèixer l’evolució dels nous casos d’infecció pel VIH notificats i el percentatge dels diagnosticats de manera tardana tenint en compte la possible via de contagi.
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- 2022
10. Prognostic implications of comorbidity patterns in critically ill COVID-19 patients: A multicenter, observational study
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Benítez, Iván D., Batlle, Jordi de, Torres, Gerard, González, Jessica, Gonzalo Calvo, David de, Targa, Adriano D.S., Gort Paniello, Clara, Moncusí Moix, Anna, Ceccato, Adrian, Fernández Barat, Laia, Ferrer, Ricard, Garcia Gasulla, Dario, Menéndez, Rosario, Motos, Anna, Peñuelas, Oscar, Riera, Jordi, Bermejo Martin, Jesús F., Peñasco, Yhivian, Ricart, Pilar, Martin Delgado, María Cruz, Aguilera, Luciano, Rodríguez, Alejandro, Boado Varela, Maria Victoria, Suarez Sipmann, Fernando, Pozo Laderas, Juan Carlos, Solé Violan, Jordi, Nieto, Maite, Novo, Mariana Andrea, Barberán, José, Amaya Villar, Rosario, Garnacho Montero, José, García Garmendia, José Luis, Gómez, José M., Lorente, José Ángel, Blandino Ortiz, Aaron, Tamayo Lomas, Luis, López Ramos, Esther, Úbeda, Alejandro, Catalán González, Mercedes, Sánchez Miralles, Angel, Martínez Varela, Ignacio, Jorge García, Ruth Noemí, Franco, Nieves, Gumucio Sanguino, Víctor D., Huerta Garcia, Arturo, Bustamante Munguira, Elena, Valdivia, Luis Jorge, Caballero, Jesús, Gallego, Elena, Martínez de la Gándara, Amalia, Castellanos Ortega, Álvaro, Trenado, Josep, Marin Corral, Judith, Albaiceta, Guillermo M., De La Torre, Maria Del Carmen, Loza-vázquez, Ana, Vidal, Pablo, Lopez Messa, Juan, Añón, José M., Carbajales Pérez, Cristina, Sagredo, Victor, Bofill, Neus, Carbonell, Nieves, Socias, Lorenzo, Barberà, Carme, Estella, Ángel, Valledor Mendez, Manuel, Diaz, Emili, López Lago, Ana, Torres, Antoni, Barbé, Ferran, CIBERESUCICOVID Project (COV20/00110, ISCIII), Universitat Politècnica de Catalunya. Departament de Ciències de la Computació, Barcelona Supercomputing Center, and Universitat Politècnica de Catalunya. KEMLG - Grup d'Enginyeria del Coneixement i Aprenentatge Automàtic
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Informàtica::Intel·ligència artificial::Aprenentatge automàtic [Àrees temàtiques de la UPC] ,Critical Care ,Health Policy ,COVID-19 ,Comorbidity ,Prognosis ,COVID-19 (Malaltia) ,COVID-19 (Disease) ,Medicina intensiva ,Oncology ,Comorbiditat ,Ciències de la salut::Medicina::Medicina comunitària i salut pública [Àrees temàtiques de la UPC] ,mental disorders ,Internal Medicine ,Critical care medicine - Abstract
Financial support was provided by Instituto de Salud Carlos III (CIBERESUCICOVID, COV20/00110), co- funded by Fondo Europeo de Desarrollo Regional (FEDER), “Una manera de hacer Europa”, Centro de Investigaci on Biom edica en Red − Enfermedades Res- piratorias (CIBERES) and Donation Program “estar pre- parados”, UNESPA, Madrid, Spain. JdB acknowledges receiving financial support from Instituto de Salud Car- los III (ISCIII; Miguel Servet 2019: CP19/00108), co- funded by the European Social Fund (ESF), “Investing in your future”. DdGC acknowledges receiving financial support from Instituto de Salud Carlos III (ISCIII; Miguel Servet 2019: CP20/00041), co-funded by the European Social Fund (ESF), “Investing in your future”. AC acknowledges receiving financial support from Instituto de Salud Carlos III (ISCIII; Sara Borrell 2021: CD21/00087)., Benítez ID, de Batlle J, Torres G, González J, de Gonzalo-Calvo D, Targa ADS, Gort-Paniello C, Moncusí-Moix A, Ceccato A, Fernández-Barat L, Ferrer R, Garcia-Gasulla D, Menéndez R, Motos A, Peñuelas O, Riera J, Bermejo-Martin JF, Peñasco Y, Ricart P, Martin Delgado MC, Aguilera L, Rodríguez A, Boado Varela MV, Suarez-Sipmann F, Pozo-Laderas JC, Solé-Violan J, Nieto M, Novo MA, Barberán J, Amaya Villar R, Garnacho-Montero J, García-Garmendia JL, Gómez JM, Lorente JÁ, Blandino Ortiz A, Tamayo Lomas L, López-Ramos E, Úbeda A, Catalán-González M, Sánchez-Miralles A, Martínez Varela I, Jorge García RN, Franco N, Gumucio-Sanguino VD, Huerta Garcia A, Bustamante-Munguira E, Valdivia LJ, Caballero J, Gallego E, Martínez de la Gándara A, Castellanos-Ortega Á, Trenado J, Marin-Corral J, Albaiceta GM, de la Torre MDC, Loza-Vázquez A, Vidal P, Lopez Messa J, Añón JM, Carbajales Pérez C, Sagredo V, Bofill N, Carbonell N, Socias L, Barberà C, Estella A, Valledor Mendez M, Diaz E, López Lago A, Torres A, Barbé F; CIBERESUCICOVID Project (COV20/00110, ISCIII)
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- 2022
11. MorbiNet Study: Hypothyroidism Comorbidity Networks in the Adult General Population
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Victor Moreno, Flora López-Simarro, Ferran Moratalla-Navarro, and Alba Aguado
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Adult ,Male ,endocrine system ,medicine.medical_specialty ,Pediatrics ,Goiter ,Adolescent ,endocrine system diseases ,Anemia ,Endocrinology, Diabetes and Metabolism ,Clinical Biochemistry ,Population ,Comorbidity ,Logistic regression ,Community Networks ,Biochemistry ,Young Adult ,Endocrinology ,Comorbiditat ,Hypothyroidism ,Risk Factors ,Internal medicine ,Prevalence ,medicine ,Humans ,Malalties cròniques ,education ,Thyroid cancer ,Aged ,Aged, 80 and over ,education.field_of_study ,business.industry ,Biochemistry (medical) ,Thyroid ,Odds ratio ,Middle Aged ,medicine.disease ,medicine.anatomical_structure ,Spain ,Case-Control Studies ,Chronic diseases ,Chronic Disease ,Female ,business ,Hipotiroïdisme - Abstract
Purpose Multimorbidity impacts quality of life. We constructed hypothyroidism comorbidity networks to identify positive and negative associations with other prevalent diseases. Methods We analyzed data of 285 342 patients with hypothyroidism from 3 135 948 adults with multimorbidity in a population-based study in Catalonia, Spain, (period: 2006-2017). We constructed hypothyroidism comorbidity networks using logistic regression models, adjusted by age and sex, and for men and women separately. We considered relevant associations those with odds ratios (OR) >1.2 or Results The conditions associated included larynx cancer (adjusted OR: 2.48), congenital anomalies (2.26), thyroid cancer (2.13), hyperthyroidism (1.66), vitamin B12/folate deficiency anemia (1.57), and goiter (1.56). The network restricted to men had more connections (mental, cardiovascular, and neurological) and stronger associations with thyroid cancer (7.26 vs 2.55), congenital anomalies (5.11 vs 2.13), hyperthyroidism (4.46 vs 1.69), larynx cancer (3.55 vs 1.67), and goiter (3.94 vs 1.64). After adjustment for comorbidities, OR values were more similar in men and women. The strongest negative associations after adjusting for comorbidities were with HIV/AIDS (OR: 0.71) and tobacco abuse (0.77). Conclusions Networks show direct and indirect hypothyroidism multimorbidity associations. The strongest connections were thyroid and larynx cancer, congenital anomalies, hyperthyroidism, anemia, and goiter. Negative associations included HIV/AIDS and tobacco abuse. The network restricted to men had more and stronger associations, but not after adjusting for comorbidities, suggesting important indirect interactions.
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- 2020
12. Bayesian variable selection and survival modeling: assessing the Most important comorbidities that impact lung and colorectal cancer survival in Spain
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Daniel Redondo-Sanchez, Rafael Marcos-Gragera, Danilo Alvares, María José Sánchez, Miguel Angel Luque-Fernandez, and Francisco J. Rubio
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Oncology ,medicine.medical_specialty ,Colorectal cancer ,Epidemiology ,Health Informatics ,Comorbidity ,Lungs -- Cancer ,Comorbidities ,Comorbiditat ,Internal medicine ,medicine ,Humans ,Pulmons -- Càncer ,Marginal effects ,Lung ,Conditional effects ,Rectum -- Cancer ,Bayesian variable selection ,business.industry ,Reproducibility of Results ,Bayes Theorem ,medicine.disease ,Cancer survival ,medicine.anatomical_structure ,Spain ,Survival modeling ,Recte -- Càncer ,business ,Colorectal Neoplasms - Abstract
Miguel Angel Luque-Fernandez is supported by a Miguel Servet I Investigator award (Grant CP17/00206) and a project grant EU-FEDER-FIS PI-18/01593 from the Instituto de Salud Carlos III, Madrid, Spain. Danilo Alvares is supported by the National Fund for Scientific and Technological Development (FONDECYT, Chile) grant number 11190018., Cancer survival represents one of the main indicators of interest in cancer epidemiology. However, the survival of cancer patients can be affected by several factors, such as comorbidities, that may interact with the cancer biology. Moreover, it is interesting to understand how different cancer sites and tumour stages are affected by different comorbidities. Identifying the comorbidities that affect cancer survival is thus of interest as it can be used to identify factors driving the survival of cancer patients. This information can also be used to identify vulnerable groups of patients with comorbidities that may lead to worst prognosis of cancer. We address these questions and propose a principled selection and evaluation of the effect of comorbidities on the overall survival of cancer patients. In the first step, we apply a Bayesian variable selection method that can be used to identify the comorbidities that predict overall survival. In the second step, we build a general Bayesian survival model that accounts for time-varying effects. In the third step, we derive several posterior predictive measures to quantify the effect of individual comorbidities on the population overall survival. We present applications to data on lung and colorectal cancers from two Spanish population-based cancer registries. The proposed methodology is implemented with a combination of the R-packages mombf and rstan. We provide the code for reproducibility at https://github.com/migariane/ BayesVarImpComorbiCancer., Miguel Servet I Investigator award CP17/00206 EU-FEDER-FIS PI-18/01593, Instituto de Salud Carlos III, Comision Nacional de Investigacion Cientifica y Tecnologica (CONICYT) CONICYT FONDECYT 11190018
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- 2022
13. Prognostic Significance of the PROFUND Index on One Year Mortality in Acute Heart Failure: Results from the RICA Registry
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Manuel Méndez-Bailon, Rosario Iguarán-Bermudez, Francesc Formiga-Pérez, José Carlos Arévalo Lorido, Iván Suárez-Pedreira, Jose Luis Morales-Rull, Ana Serrado-Iglesias, Pau Llacer-Iborra, Gabriela Ormaechea-Gorricho, Francisco Javier Carrasco-Sánchez, Jesús Casado-Cerrada, Emmanuel Andrès, Jesús Diez-Manglano, Noel Lorenzo-Villalba, and Manuel Montero-Pérez-Barquero
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heart failure ,comorbidities ,PROFUND index ,Comorbiditat ,Pronòstic mèdic ,Heart failure ,General Medicine ,Insuficiència cardíaca ,Comorbidity ,Older people ,Cardiología ,Prognosis ,Persones grans - Abstract
Background: Heart failure (HF) is a syndrome with high prevalence, mainly affecting elderly patients, where the presence of associated comorbidities is of great importance. Methods: An observational study from a prospective registry was conducted. Patients identified from the National Registry of Heart Failure (RICA), which belongs to the Working Group on Heart Failure and Atrial Fibrillation of the Spanish Society of Internal Medicine (SEMI), were included. The latter is a prospective, multicenter registry that has been active since 2008. It includes individual consecutive patients over 50 years of age with a diagnosis of HF at hospital discharge (acute decompensated or new-onset HF). Results: In total, 5424 patients were identified from the registry. Forty-seven percent were men and mean left ventricular ejection fraction (LVEF) was 51.4%; 1132 had a score of 0 to 2 according to the PROFUND index, 3087 had a score of 3 to 6, and 952 patients had a score of 7 to 10 points. In the sample, 252 patients had a score above 11 points. At the end of the year of follow-up, 61% of the patients died. This mortality increased proportionally as the PROFUND index increased, specifically 75% for patients with PROFUND greater than 11. The Kaplan-Meier survival curve shows that survival at one year progressively decreases as the PROFUND index value increases. Thus, subjects with scores greater than seven (intermediate-high and high-risk) presented the worst survival with a log rank of 0.96 and a p < 0.05. In the regression analysis, we found a higher risk of death from any cause at one year in the group with the highest risk according to the PROFUND index (score greater than 11 points (HR 1.838 (1.410–2.396)). Conclusions: The PROFUND index is a good index for predicting mortality in patients admitted for acute HF, especially in those subjects at intermediate to high risk with scores above seven. Future studies should seek to determine whether the PROFUND index score is simply a prognostic marker or whether it can also be used to make therapeutic decisions for those subjects with very high short-term mortality.
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- 2022
14. Multimorbidity and short-term overall mortality among colorectal cancer patients in Spain: A population-based cohort study
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Shing F. Lee, Rafael Marcos-Gragera, Daniel Redondo-Sanchez, Miguel Rodríguez-Barranco, Mª Carme Carmona-Garcia, Elena Salamanca-Fernández, Karen dos Santos Gonçalves, María José Sánchez, and Miguel Angel Luque-Fernandez
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Male ,0301 basic medicine ,Cancer Research ,Colorectal cancer ,Comorbidity ,0302 clinical medicine ,Risk Factors ,Cause of Death ,Epidemiology of cancer ,Prevalence ,Cumulative incidence ,Registries ,Cancer ,Rectum -- Cancer ,Aged, 80 and over ,Incidence ,Hazard ratio ,Middle Aged ,Treatment Outcome ,medicine.anatomical_structure ,Oncology ,030220 oncology & carcinogenesis ,Female ,Colorectal Neoplasms ,medicine.medical_specialty ,Rectum ,Risk Assessment ,03 medical and health sciences ,Cancer epidemiology ,Comorbiditat ,Rheumatic Diseases ,Internal medicine ,Diabetes Mellitus ,medicine ,Humans ,Survival analysis ,Aged ,Heart Failure ,business.industry ,Multimorbidity ,medicine.disease ,Survival Analysis ,030104 developmental biology ,Spain ,Recte -- Càncer ,business ,Follow-Up Studies - Abstract
Background Numerous studies have analysed the effect of comorbidity on cancer outcomes, but evidence on the association between multimorbidity and short-term mortality among colorectal cancer patients is limited. We aimed to assess this association and the most frequent patterns of multimorbidity associated with a higher short-term mortality risk among colorectal cancer patients in Spain. Methods Data were obtained from two Spanish population-based cancer registries and electronic health records. We estimated the unadjusted cumulative incidence of death by comorbidity status at 6 months and 1 year. We used a flexible parametric model to derive the excess mortality hazard ratios (HRs) for multimorbidity after adjusting for sex, age at diagnosis, cancer stage and treatment. We estimated the adjusted cumulative incidence of death by comorbidity status and identified multimorbidity patterns. Results Among the study participants, 1,048 cases were diagnosed with cancers of the colon and rectum, 2 cases with cancer of the anus with overlapping sites of the rectum and 11 cases with anal adenocarcinomas but treated as colorectal cancer patients. Among 1,061 colorectal cancer patients, 171 (16.2%) died before 6 months, 246 (23.3%) died before the 1-year follow-up, and 324 (30.5%) had multimorbidity. Patients with multimorbidity had two times higher mortality risk than those without comorbidities at 6 months (adjusted HR: 2.04; 95% confidence interval [CI]: 1.30–3.20, p = 0.002). The most frequent multimorbidity pattern was congestive heart failure + diabetes. However, patients with rheumatologic disease + diabetes had two times higher 1-year mortality risk than those without comorbidities (HR: 2.23; 95% CI: 1.23–4.07, p = 0.008). Conclusions Multimorbidity was a strong independent predictor of short-term mortality at 6 months and 1 year among the colorectal cancer patients in Spain. The identified multimorbidity pattern was consistent. Our findings might help identify patients at a higher risk for poor cancer and treatment outcomes M.A.L.F. received support from the Instituto de Salud Carlos III, Madrid, Spain (grant/award no. CP17/ 00206-EU-FEDER), and M.J.S. received support from the Andalusian Department of Health (grant no. PI0152/2017)
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- 2020
15. Identification of genetic variants influencing methylation in brain with pleiotropic effects on psychiatric disorders
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Bru Cormand, Phil Lee, Judit Cabana-Domínguez, Laura Pineda-Cirera, and Noèlia Fernàndez-Castillo
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Epigenomics ,medicine.medical_specialty ,Candidate gene ,Gene Expression ,Genomics ,Genome-wide association study ,Single-nucleotide polymorphism ,Diseases ,Comorbidity ,Biology ,Polymorphism, Single Nucleotide ,Comorbiditat ,medicine ,Humans ,Epigenetics ,Psiquiatria ,Psychiatry ,Gene ,Biological Psychiatry ,Pharmacology ,Mental Disorders ,Brain ,Genetic Pleiotropy ,DNA Methylation ,Expressió gènica ,Phenotype ,DNA methylation ,Malalties ,Gene expression ,Functional genomics - Abstract
Psychiatric disorders affect 29% of the global population at least once in the lifespan, and genetic studies have proved a shared genetic basis among them, although the underlying molecular mechanisms remain largely unknown. DNA methylation plays an important role in complex disorders and, remarkably, enrichment of common genetic variants influencing allele-specific methylation (ASM) has been reported among variants associated with specific psychiatric disorders. In the present study we assessed the contribution of ASM to a set of eight psychiatric disorders by combining genetic, epigenetic and expression data. We interrogated a list of 3896 ASM tagSNPs in the brain in the summary statistics of a cross-disorder GWAS meta-analysis of eight psychiatric disorders from the Psychiatric Genomics Consortium, including more than 162,000 cases and 276,000 controls. We identified 80 SNPs with pleiotropic effects on psychiatric disorders that show an opposite directional effect on methylation and gene expression. These SNPs converge on eight candidate genes: ZSCAN29, ZSCAN31, BTN3A2, DDAH2, HAPLN4, ARTN, FAM109B and NAGA. ZSCAN29 shows the broadest pleiotropic effects, showing associations with five out of eight psychiatric disorders considered, followed by ZSCAN31 and BTN3A2, associated with three disorders. All these genes overlap with CNVs related to cognitive phenotypes and psychiatric traits, they are expressed in the brain, and seven of them have previously been associated with specific psychiatric disorders, supporting our results. To sum up, our integrative functional genomics analysis identified eight psychiatric disease risk genes that impact a broad list of disorders and highlight an etiologic role of SNPs that influence DNA methylation and gene expression in the brain.
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- 2022
16. Nationwide COVID-19-EII Study: Incidence, Environmental Risk Factors and Long-Term Follow-Up of Patients with Inflammatory Bowel Disease and COVID-19 of the ENEIDA Registry
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Zabana Y, Marín-Jiménez I, Rodríguez-Lago I, Vera I, Martín-Arranz MD, Guerra I, Gisbert JP, Mesonero F, Benítez O, Taxonera C, Ponferrada-Díaz Á, Piqueras M, Lucendo AJ, Caballol B, Mañosa M, Martínez-Montiel P, Bosca-Watts M, Gordillo J, Bujanda L, Manceñido N, Martínez-Pérez T, López A, Rodríguez-Gutiérrez C, García-López S, Vega P, Rivero M, Melcarne L, Calvo M, Iborra M, Barreiro de-Acosta M, Sicilia B, Barrio J, Pérez JL, Busquets D, Pérez-Martínez I, Navarro-Llavat M, Hernández V, Argüelles-Arias F, Ramírez Esteso F, Meijide S, Ramos L, Gomollón F, Muñoz F, Suris G, de Zarate JO, Huguet JM, Llaó J, García-Sepulcre MF, Sierra M, Durà M, Estrecha S, Fuentes Coronel A, Hinojosa E, Olivan L, Iglesias E, Gutiérrez A, Varela P, Rull N, Gilabert P, Hernández-Camba A, Brotons A, Ginard D, Sesé E, Carpio D, Aceituno M, Cabriada JL, González-Lama Y, Jiménez L, Chaparro M, López-San Román A, Alba C, Plaza-Santos R, Mena R, Tamarit-Sebastián S, Ricart E, Calafat M, Olivares S, Navarro P, Bertoletti F, Alonso-Galán H, Pajares R, Olcina P, Manzano P, Domènech E, Esteve M, On Behalf Of The Eneida Registry Of Geteccu, [Zabana Y] Hospital Universitari Mútua Terrassa, Terrassa, Spain. Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, Spain. [Marín-Jiménez I] Hospital Gregorio Marañón, Madrid, Spain. [Rodríguez-Lago I] Gastroenterology Department, Hospital Universitario de Galdakao, Galdakao, Spain. Biocruces Bizkaia Health Research Institute, Galdakao, Spain. [Vera I] Hospital Universitario Puerta de Hierro, Majadahonda, Spain. [Martín-Arranz MD] Hospital Universitario La Paz, Madrid, Spain. [Guerra I] Hospital Universitario de Fuenlabrada, Fuenlabrada, Spain. Instituto de Investigación Hospital Universitario La Paz (IdiPaz), Madrid, Spain. [Piqueras M, Mena R] Servei de Digestologia, Hospital de Terrassa, Consorci Sanitari de Terrassa, Terrassa, Spain, Consorci Sanitari de Terrassa, and Universidad de Sevilla. Departamento de Medicina
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index ,Pronòstic mèdic ,Risk factors in diseases ,COVID-19 (Malaltia) ,Article ,Inflammatory bowel disease ,Comorbiditat ,inflammatory bowel disease ,virosis::infecciones por virus ARN::infecciones por Nidovirales::infecciones por Coronaviridae::infecciones por Coronavirus [ENFERMEDADES] ,Epidemiology and Biostatistics::Epidemiology::Health-Disease Process::Comorbidity [PUBLIC HEALTH] ,Factors de risc en les malalties ,SARS-CoV-2 ,COVID-19 ,determinants ,Virus Diseases::RNA Virus Infections::Nidovirales Infections::Coronaviridae Infections::Coronavirus Infections [DISEASES] ,General Medicine ,Prognosis ,enfermedades del sistema digestivo::enfermedades gastrointestinales::enfermedades del sistema digestivo::enfermedades gastrointestinales::enfermedades intestinales::enfermedad inflamatoria intestinal [ENFERMEDADES] ,infection ,epidemiología y bioestadística::epidemiología::proceso salud-enfermedad::comorbilidad [SALUD PÚBLICA] ,Medicine ,Digestive System Diseases::Gastrointestinal Diseases::Digestive System Diseases::Gastrointestinal Diseases::Intestinal Diseases::Inflammatory Bowel Diseases [DISEASES] ,Intestins - Inflamació - Abstract
We aim to describe the incidence and source of contagion of COVID-19 in patients with IBD, as well as the risk factors for a severe course and long-term sequelae. This is a prospective observational study of IBD and COVID-19 included in the ENEIDA registry (53,682 from 73 centres) between March-July 2020 followed-up for 12 months. Results were compared with data of the general population (National Centre of Epidemiology and Catalonia). A total of 482 patients with COVID-19 were identified. Twenty-eight percent were infected in the work environment, and 48% were infected by intrafamilial transmission, despite having good adherence to lockdown. Thirty-five percent required hospitalization, 7.9% had severe COVID-19 and 3.7% died. Similar data were reported in the general population (hospitalisation 19.5%, ICU 2.1% and mortality 4.6%). Factors related to death and severe COVID-19 were being aged >= 60 years (OR 7.1, 95% CI: 1.8-27 and 4.5, 95% CI: 1.3-15.9), while having >= 2 comorbidities increased mortality (OR 3.9, 95% CI: 1.3-11.6). None of the drugs for IBD were related to severe COVID-19. Immunosuppression was definitively stopped in 1% of patients at 12 months. The prognosis of COVID-19 in IBD, even in immunosuppressed patients, is similar to that in the general population. Thus, there is no need for more strict protection measures in IBD. This study is funded by the Carlos III Health Institute (COV20/00227: Co-IP Dra. Maria Esteve and Dra. Yamile Zabana), FEDER (Fondo Europeo de Desarrollo Regional) and supported by GETECCU. The ENEIDA Registry of GETECCU is supported by Takeda, Pfizer, Galapagos, AbbVie and Biogen.
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- 2022
17. Higher frequency of comorbidities in fully vaccinated patients admitted to the ICU due to severe COVID-19: a prospective, multicentre, observational study
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Isciii, Alexandre López-Gavín, Rosario Menéndez, Laia Fernández-Barat, Albert Gabarrus, Anna Motos, Ferran Roche-Campo, Susana Sancho Chinesta, David de Gonzalo-Calvo, José A. Lorente, Raquel Pérez-Arnal, Adrian Ceccato, Ferran Barbé, Alejandro Rodriguez, Raquel Almansa, Judith Marin-Corral, Ricard Ferrer, Oscar Peñuelas, Antoni Torres, Pilar Ricart, Jesus F. Bermejo-Martin, Dario Garcia-Gasulla, Lorenzo Socias, Jordi Riera, Barcelona Supercomputing Center, and Universitat Politècnica de Catalunya. Departament de Ciències de la Computació
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Pulmonary and Respiratory Medicine ,2019-20 coronavirus outbreak ,Pediatrics ,medicine.medical_specialty ,Coronavirus disease 2019 (COVID-19) ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,MEDLINE ,Comorbidity ,Vacunes ,Infeccions per coronavirus ,COVID-19 (Malaltia) ,Comorbidities ,Informàtica::Aplicacions de la informàtica [Àrees temàtiques de la UPC] ,COVID-19 (Disease) ,Comorbiditat ,Research Letter ,Humans ,Medicine ,Prospective Studies ,Vaccines ,business.industry ,SARS-CoV-2 ,COVID-19 ,Vaccination ,Hospitalization ,Intensive Care Units ,ICU ,Observational study ,business ,Vaccine response - Abstract
Severe COVID-19 disease requiring ICU admission is possible in the fully vaccinated population, especially in those with immunocompromised status and other comorbidities. Interventions to improve vaccine response might be necessary in this population. Peer Reviewed "Article signat per 23 autors/es: Anna Motos, Alexandre López-Gavín, Jordi Riera, Adrián Ceccato, Laia Fernández-Barat, Jesús F. Bermejo-Martin, Ricard Ferrer, David de Gonzalo-Calvo, Rosario Menéndez, Raquel Pérez-Arnal, Dario García-Gasulla, Alejandro Rodriguez, Oscar Peñuelas, José Ángel Lorente, Raquel Almansa, Albert Gabarrus, Judith Marin-Corral, Pilar Ricart, Ferran Roche-Campo, Susana Sancho Chinesta, Lorenzo Socias, Ferran Barbé, Antoni Torres on behalf of the CIBERESUCICOVID Project (COV20/00110, ISCIII)"
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- 2022
18. Loneliness as a risk factor for high level of comorbidities and low quality of life in elderly population (non solum study): multicentered prospective cohort study
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Ramon Grimalt, Meritxell, Universitat de Girona. Facultat de Medicina, Cordón Granados, Ferran, and Marcos-Gragera, Rafael
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Older people -- Diseases -- Risk factors ,Comorbiditat ,Solitud ,Loneliness ,Persones grans -- Malalties -- Factors de risc ,Comorbidity ,Older people ,Persones grans - Abstract
BACKGROUND Loneliness is a very common feeling in our environment and it can be a very intense experience in older people, due to the loss of complete abilities and capacities, which are fully complete when we are younger. Especially chronic loneliness is the one that has been more related to health problems, both physical and mental. Comorbidity on elderly population seems to be a good way to correlate all pathologies and deficits they suffer. Comorbidity hinders the process of a good state of health. It must be treated as a global condition with comprehensive approach according to severity, prognosis and possibility to treat. Nowadays quality of life has become more important in clinical practice, it is no longer following a paternalist model. Today patient’s opinion is taken into account regarding his or her state of health. That is why quality of life is an information needed in investigations and mostly on elder population who seems to have a worse perception of health state and quality of life. OBJECTIVES The main objectives of this study are to evaluate if people who suffer loneliness could develop a major level of comorbidities and develop a worse perception of their quality of life DESIGN This study has been designed as a multicentric prospective dynamic cohort study. METHODS Data will be obtained with Estació Clinica d’Atenció Primària (ECAP) program, which is registered in routine medical visits. An ECAP manager will recruit all people who fulfill our criteria and then we will randomly select 401 candidates. To assure we do not have enough participants we will randomly select another 10%. So, at the end we will select a sample of 441 possible candidates. We will follow-up our participants during six years and administer them University of California, Los Angeles (UCLA) Loneliness Scale, Cumulative Illness Rating Scale- Geriatrics (CIRS-G) and QL-5D-5L each year. All data collection will be performed on the ECAP program, specifically on “Intel·ligència Clínica Activa”, where there will be a section with the name of the study, Non Solum. PARTICIPANTS The exposed cohort will include individuals who are 65 years old or over who feel lonely and the non-exposed cohort will include people aged 65 years old or over who do not feel loneliness. All of them will be from Girona Health Region
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- 2022
19. Prevalence and associations of metabolic syndrome in patients with alcohol use disorder
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Anna Hernández-Rubio, Arantza Sanvisens, Ferran Bolao, Isabel Cachón-Suárez, Carme Garcia-Martín, Antoni Short, Ramón Bataller, and Roberto Muga
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Adult ,Male ,Metabolic Syndrome ,Multidisciplinary ,Alcohol Drinking ,Age Factors ,Metabolic disorders ,Endocrine system and metabolic diseases ,Addiction ,Hyperuricemia ,gamma-Glutamyltransferase ,Comorbidity ,Middle Aged ,Alcoholism ,Comorbiditat ,Risk Factors ,Alcoholisme ,Prevalence ,Humans ,Female ,Glomerular Filtration Rate - Abstract
Excessive alcohol consumption has been associated with different components of the metabolic syndrome (MetS) such as arterial hypertension, dyslipidemia, type 2 diabetes or obesity. We aimed to analyze the prevalence and associations of MetS in patients with Alcohol Use Disorder (AUD). Cross-sectional study in heavy drinkers admitted for the treatment of AUD between 2013 and 2017. Medical comorbidity, anthropometric data, alcohol use and biological parameters were obtained. MetS was established according to the harmonized definition. A total of 728 patients (22% women) were included; median age was 47 years (IQR: 40–53.5), median alcohol consumption was 160 g/day (IQR: 115–240) and prevalence of MetS was 13.9%. The multivariate analysis showed a significant dose–response effect of estimated glomerular filtration (eGFR) and MetS: relative to patients with eGFR > 90 mL/min, those with eGFR (60–90 mL/min) and those with eGFR
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- 2022
20. Focusing on Comorbidity—A Novel Meta-Analytic Approach and Protocol to Disentangle the Specific Neuroanatomy of Co-occurring Mental Disorders
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Lydia Fortea, Anton Albajes-Eizagirre, Yuan-Wei Yao, Edu Soler, Norma Verdolini, Alexander O. Hauson, Adriana Fortea, Santiago Madero, Aleix Solanes, Scott C. Wollman, Maria Serra-Blasco, Toby Wise, Steve Lukito, Maria Picó-Pérez, Christina Carlisi, JinTao Zhang, PingLei Pan, Álvar Farré-Colomés, Danilo Arnone, Matthew J. Kempton, Carles Soriano-Mas, Katya Rubia, Luke Norman, Paolo Fusar-Poli, David Mataix-Cols, Marc Valentí, Esther Via, Narcis Cardoner, Marco Solmi, Jae I. Shin, Eduard Vieta, and Joaquim Radua
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magnetic resonance imaging (MRI) ,mental disorder ,seed-based d mapping (SDM) ,RC435-571 ,Comorbidity ,Medication ,Study Protocol ,Magnetic resonance imaging ,Comorbiditat ,Diagnòstic ,Imatges per ressonància magnètica ,Diagnosis ,mental disorders ,Gray matter (GM) ,Magnetic resonance imaging (MRI) ,Psychiatry ,Seed-based d mapping (SDM) ,meta-analysis ,Psychiatry and Mental health ,Meta-analysis ,Mental disorder ,comorbidity ,Mental illness ,medication ,Malalties mentals ,gray matter (GM) - Abstract
BackgroundIn mental health, comorbidities are the norm rather than the exception. However, current meta-analytic methods for summarizing the neural correlates of mental disorders do not consider comorbidities, reducing them to a source of noise and bias rather than benefitting from their valuable information.ObjectivesWe describe and validate a novel neuroimaging meta-analytic approach that focuses on comorbidities. In addition, we present the protocol for a meta-analysis of all major mental disorders and their comorbidities.MethodsThe novel approach consists of a modification of Seed-based d Mapping—with Permutation of Subject Images (SDM-PSI) in which the linear models have no intercept. As in previous SDM meta-analyses, the dependent variable is the brain anatomical difference between patients and controls in a voxel. However, there is no primary disorder, and the independent variables are the percentages of patients with each disorder and each pair of potentially comorbid disorders. We use simulations to validate and provide an example of this novel approach, which correctly disentangled the abnormalities associated with each disorder and comorbidity. We then describe a protocol for conducting the new meta-analysis of all major mental disorders and their comorbidities. Specifically, we will include all voxel-based morphometry (VBM) studies of mental disorders for which a meta-analysis has already been published, including at least 10 studies. We will use the novel approach to analyze all included studies in two separate single linear models, one for children/adolescents and one for adults.DiscussionThe novel approach is a valid method to focus on comorbidities. The meta-analysis will yield a comprehensive atlas of the neuroanatomy of all major mental disorders and their comorbidities, which we hope might help develop potential diagnostic and therapeutic tools.
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- 2022
21. Survival analysis of lymphoid neoplasms and impact of comorbidity in patients with chronic lymphocytic leukemia in Girona: a population-based study
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Villavicencio Obando, Alicia Silvana, Sáez Zafra, Marc, Marcos-Gragera, Rafael, Solans Margalef, Marta, Universitat de Girona. Departament d'Economia, Universitat de Girona. Departament d'Infermeria, and Solans Margalef, Marta
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Neoplàsies limfoides ,Leucèmia limfàtica crònica ,Supervivencia ,Survival ,616.4 ,Comorbidity ,Cáncer ,Leucemia linfoide crónica ,Comorbilidad ,Lymphoid neoplasms ,Comorbiditat ,Mortalidad ,Mortalitat ,616 - Patologia. Medicina clínica. Oncologia ,Chronic lymphocytic leukemia ,Mortality ,616.4 - Patologia del sistema limfàtic, òrgans hematopoètics, endocrins ,Càncer ,Supervivència ,Neoplasias linfoides ,Cancer - Abstract
Comprehensive population-based studies assessing the survival of hematological entities are scarce and typically conducted using old classifications schemes, which hampers their interpretation and international comparisons. Therefore, this thesis is aimed at studying the survival of lymphoid neoplasms (LNs) and its subtypes in the province of Girona, according to the 2008 World Health Organization (WHO) classification. It further provides a sub-analysis focused on estimating the prevalence of comorbidities and their potential impact on survival and mortality (related or not to chronic lymphocytic leukemia (CLL)) of patients diagnosed with CLL. Data were extracted from the Girona Cancer Registry between 1996-2015 for all LNs and observed survival (OS) and relative survival (RS) were calculated using the Kaplan Meier and Pohar Perme methods, respectively. For the CLL sub-analysis, we focused on a more recent period (2008-2016) in order to have access to computerized medical records. Clinical variables were collected at diagnoses and comorbidities were assessed using Charlson Comorbidity Index (CCI). The 5-year RS of the LNs was 62.3% (95% confidence interval (CI): 60.4–64.4) and varied notably according to the different subtypes. The RS of all LNs progressively decreased with advancing patient age, and an increase in RS was observed during 1996-2002 and 2003-2008. In the CLL sub-analysis, survival decreased markedly with increasing CCI scores, but the effect of CCI score disappeared when age and stage are also considered. On the other hand, the CCI score does not play a role predictor of mortality. In conclusion, the LNs survival analysis related possible changes in survival probability to improvements in both diagnostic approach and treatment of the different LNs. Moreover, the high-resolution sub-analysis of CLL cases further allowed us to identify how survival was conditioned by comorbidities at diagnosis Els estudis complets basats en la població que avaluen la supervivència de les entitats hematològiques són rars i sovint es duen a terme utilitzant antics esquemes de classificació, cosa que dificulta la interpretació i dificulta les comparacions internacionals. Per això, aquesta tesi té com a objectiu estudiar la supervivència de les neoplàsies limfoides (NLs) i els seus subtipus a la província de Girona, segons la classificació de l'Organització Mundial de la Salut (OMS) de 2008. A més, es realitza un subanàlisi centrat en l'estimació de la prevalença de comorbiditats i el seu impacte potencial en la supervivència i mortalitat (relacionada o no amb la leucèmia limfàtica crònica (LLC)) dels pacients diagnosticats de LLC. Les dades es van extreure del Registre del Càncer de Girona entre 1996 i 2015 per a tots els NLs i es van calcular la supervivència observada (SO) i la supervivència relativa (SR) utilitzant els mètodes de Kaplan Meier i Pohar Perme, respectivament. Per al subanàlisi de LLC, ens vam centrar en un període més recent (2008-2016) per tenir accés a registres mèdics informatitzats. Les variables clíniques es van recollir en el diagnòstic i les comorbiditats es van avaluar utilitzant l'índex de comorbiditat de Charlson (ICC). La SR a 5 anys per als NLs va ser 62,3% (interval de confiança del 95%: 60,4-64,4) i va variar notablement entre subtipus. La SR de totes les NLs va disminuir progressivament amb l'edat avançada dels pacients, i es va observar un augment de SR durant 1996-2002 i 2003-2008. Al subanàlisi de LLC, la supervivència va disminuir notablement amb l'augment de la puntuació de l’ICC, però l'efecte de la puntuació de l’ICC va desaparèixer quan també es va considerar l'edat i l' estadi. D'altra banda, la puntuació de la ICC no juga un paper predictiu de la mortalitat. En conclusió, l'anàlisi de supervivència de NLs va relacionar possibles canvis en les probabilitats de supervivència a millores tant en l'enfocament diagnòstic com en el tractament de diferents NLs. A més, el subanàlisi d'alta resolució dels casos de LLC també va permetre identificar com la supervivència estava condicionada per les comorbiditats en el moment del diagnòstic Programa de Doctorat en Biologia Molecular, Biomedicina i Salut
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- 2022
22. Guillain-Barré syndrome after SARS-CoV-2 infection in an international prospective cohort study
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Luijten, LWG, Leonhard, SE, van der Eijk, AA, Doets, AY, Appeltshauser, L, Arends, S, Attarian, S, Benedetti, L, Briani, C, Casasnovas, C, Castellani, F, Dardiotis, E, Echaniz-Laguna, A, Garssen, MPJ, Harbo, T, Huizinga, R, Humm, AM, Jellema, K, van der Kooi, AJ, Kuitwaard, K, Kuntzer, T, Kusunoki, S, Lascano, AM, Martinez-Hernandez, E, Rinaldi, S, Samijn, JPA, Scheidegger, O, Tsouni, P, Vicino, A, Visser, LH, Walgaard, C, Wang, YZ, Wirtz, PW, Ripellino, P, Jacobs, BC, Martín-Aguilar L, Zivkovic, Sasa A., Neurology, Virology, Immunology, Luijten, L, Leonhard, S, van der Eijk, A, Doets, A, Appeltshauser, L, Arends, S, Attarian, S, Benedetti, L, Briani, C, Casasnovas, C, Castellani, F, Dardiotis, E, Echaniz-Laguna, A, Garssen, M, Harbo, T, Huizinga, R, Humm, A, Jellema, K, van der Kooi, A, Kuitwaard, K, Kuntzer, T, Kusunoki, S, Lascano, A, Martinez-Hernandez, E, Rinaldi, S, Samijn, J, Scheidegger, O, Tsouni, P, Vicino, A, Visser, L, Walgaard, C, Wang, Y, Wirtz, P, Ripellino, P, Jacobs, B, Cavaletti, G, AII - Infectious diseases, ANS - Neuroinfection & -inflammation, and EURO-NMD
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Adult ,Male ,Pediatrics ,medicine.medical_specialty ,Autoimmune diseases ,Guillain-Barre Syndrome/epidemiology ,610 Medicine & health ,Comorbidity ,Guillain-Barre syndrome ,Settore MED/26 ,Cohort Studies ,Campylobacter Jejuni Infection ,Comorbiditat ,Interquartile range ,preceding infection ,Pandemic ,medicine ,Humans ,Prospective Studies ,Prospective cohort study ,Aged ,Malalties autoimmunitàries ,AcademicSubjects/SCI01870 ,business.industry ,SARS-CoV-2 ,COVID-19 ,Retrospective cohort study ,Original Articles ,Guillain-Barré ,Middle Aged ,clinical phenotype ,medicine.disease ,syndrome ,preceding infections ,COVID-19/complications ,Population study ,AcademicSubjects/MED00310 ,Female ,Neurology (clinical) ,business ,Cohort study - Abstract
In the wake of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, an increasing number of patients with neurological disorders, including Guillain-Barré syndrome (GBS), have been reported following this infection. It remains unclear, however, if these cases are coincidental or not, as most publications were case reports or small regional retrospective cohort studies. The International GBS Outcome Study is an ongoing prospective observational cohort study enrolling patients with GBS within 2 weeks from onset of weakness. Data from patients included in this study, between 30 January 2020 and 30 May 2020, were used to investigate clinical and laboratory signs of a preceding or concurrent SARS-CoV-2 infection and to describe the associated clinical phenotype and disease course. Patients were classified according to the SARS-CoV-2 case definitions of the European Centre for Disease Prevention and Control and laboratory recommendations of the World Health Organization. Forty-nine patients with GBS were included, of whom eight (16%) had a confirmed and three (6%) a probable SARS-CoV-2 infection. Nine of these 11 patients had no serological evidence of other recent preceding infections associated with GBS, whereas two had serological evidence of a recent Campylobacter jejuni infection. Patients with a confirmed or probable SARS-CoV-2 infection frequently had a sensorimotor variant 8/11 (73%) and facial palsy 7/11 (64%). The eight patients who underwent electrophysiological examination all had a demyelinating subtype, which was more prevalent than the other patients included in the same time window [14/30 (47%), P = 0.012] as well as historical region and age-matched control subjects included in the International GBS Outcome Study before the pandemic [23/44 (52%), P = 0.016]. The median time from the onset of infection to neurological symptoms was 16 days (interquartile range 12–22). Patients with SARS-CoV-2 infection shared uniform neurological features, similar to those previously described in other post-viral GBS patients. The frequency (22%) of a preceding SARS-CoV-2 infection in our study population was higher than estimates of the contemporaneous background prevalence of SARS-CoV-2, which may be a result of recruitment bias during the pandemic, but could also indicate that GBS may rarely follow a recent SARS-CoV-2 infection. Consistent with previous studies, we found no increase in patient recruitment during the pandemic for our ongoing International GBS Outcome Study compared to previous years, making a strong relationship of GBS with SARS-CoV-2 unlikely. A case-control study is required to determine if there is a causative link or not., Luijten et al. report that patients with Guillain-Barré syndrome (GBS) after SARS-CoV-2 infection share uniform neurological features, similar to those previously described in other cases of post-viral GBS. They conclude that SARS-CoV-2 infection may be an occasional trigger for GBS, but that a strong association is unlikely.
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- 2021
23. The adjusted morbidity groups (GMA): an exhaustive and severity-balanced tool for risk assessment
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Valero-Bover, Damià, Vela-Vallespín, Emili, Clèries, Montse, Monterde, David, Carot-Sans, Gerard, Cano, Isaac, Piera-Jiménez, Jordi, Pérez Sust, Pol, [Valero-Bover D, Vela E, Clèries M, Carot-Sans G, Piera-Jiménez J] Servei Català de la Salut (CatSalut), Generalitat de Catalunya, Barcelona, Spain. Digitalization for the Sustainability of the Healthcare System (DS3), Sistema de Salut de Catalunya, Barcelona, Spain. [Monterde D] Digitalization for the Sustainability of the Healthcare System (DS3), Sistema de Salut de Catalunya, Barcelona, Spain. Institut Català de la Salut (ICS), Barcelona, Spain. [Cano I] Hospital Clínic de Barcelona, Barcelona, Spain. Institut d'Investigacions Biomèdiques Agustí Pi i Sunyer (IDIBAPS), Barcelona, Spain. Departament de Medicina, Universitat de Barcelona (UB), Barcelona, Spain. [Pérez Sust P] Servei Català de la Salut (CatSalut), Generalitat de Catalunya, Barcelona, Spain, and Departament de Salut
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Comorbiditat ,epidemiología y bioestadística::epidemiología::proceso salud-enfermedad::comorbilidad [SALUD PÚBLICA] ,Investigative Techniques::Epidemiologic Methods::Data Collection::Surveys and Questionnaires::Health Surveys::Health Status Indicators [ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT] ,calidad, acceso y evaluación de la atención sanitaria::calidad de la atención sanitaria::factores epidemiológicos::comorbilidad [ATENCIÓN DE SALUD] ,Indicadors de salut ,técnicas de investigación::métodos epidemiológicos::recopilación de datos::encuestas y cuestionarios::encuestas de salud::indicadores de salud [TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS] ,Malalties - Avaluació del risc ,Health Care Quality, Access, and Evaluation::Quality of Health Care::Epidemiologic Factors::Comorbidity [HEALTH CARE] ,Epidemiology and Biostatistics::Epidemiology::Health-Disease Process::Comorbidity [PUBLIC HEALTH] - Abstract
Grups morbiditat ajustada; GMA; Eina d'estratificació; Avaluació de riscos Grupos morbilidad ajustada; GMA; Herramienta de estratificación; Evaluación de riesgos Adjusted morbidity groups; GMA; Stratification tool; Risk assessment Els GMA consisteixen en una eina que permet avaluar el risc en salut a partir de les característiques demogràfiques dels pacients, les seves malalties cròniques i aquelles situacions o malalties agudes que puguin tenir-hi impacte. Aquesta eina proporciona un índex de risc que es pot utilitzar com a factor d’ajust en models específics d’una determinada malaltia i a la vegada actua com un agrupament per estratificar la població en diferents nivells de risc. Los GMA consisten en una herramienta que permite evaluar el riesgo en salud a partir de las características demográficas de los pacientes, sus enfermedades crónicas y aquellas situaciones o enfermedades agudas que puedan tener impacto. Esta herramienta proporciona un índice de riesgo que se puede utilizar como factor de ajuste en modelos específicos de una determinada enfermedad y al mismo tiempo actúa como un agrupamiento para estratificar la población en diferentes niveles de riesgo. GMAs are a tool that assesses health risk based on the demographic characteristics of patients, their chronic diseases and those situations or acute diseases that may have an impact. This tool provides a risk index that can be used as an adjustment factor in specific models of a given disease and at the same time acts as a grouping to stratify the population at different levels of risk.
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- 2021
24. Physiological Changes and Pathological Pain Associated with Sedentary Lifestyle-Induced Body Systems Fat Accumulation and Their Modulation by Physical Exercise
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Enrique Verdú Navarro, Judit Homs Avila, and Pere Boadas-Vaello
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adipose tissue and body systems crosstalking ,obesity ,Health, Toxicology and Mutagenesis ,pathological pain ,Public Health, Environmental and Occupational Health ,Pain ,chemokines ,Comorbidity ,Review ,Overweight ,Greix ,cytokines ,Sedentary behavior ,Sedentarisme ,Comorbiditat ,Adipose Tissue ,Fat ,physical exercise ,Medicine ,Humans ,Dolor ,Sedentary Behavior ,Exercise - Abstract
A sedentary lifestyle is associated with overweight/obesity, which involves excessive fat body accumulation, triggering structural and functional changes in tissues, organs, and body systems. Research shows that this fat accumulation is responsible for several comorbidities, including cardiovascular, gastrointestinal, and metabolic dysfunctions, as well as pathological pain behaviors. These health concerns are related to the crosstalk between adipose tissue and body systems, leading to pathophysiological changes to the latter. To deal with these health issues, it has been suggested that physical exercise may reverse part of these obesity-related pathologies by modulating the cross talk between the adipose tissue and body systems. In this context, this review was carried out to provide knowledge about (i) the structural and functional changes in tissues, organs, and body systems from accumulation of fat in obesity, emphasizing the crosstalk between fat and body tissues; (ii) the crosstalk between fat and body tissues triggering pain; and (iii) the effects of physical exercise on body tissues and organs in obese and non-obese subjects, and their impact on pathological pain. This information may help one to better understand this crosstalk and the factors involved, and it could be useful in designing more specific training interventions (according to the nature of the comorbidity).
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- 2021
25. Markers of Monocyte Activation, Inflammation, and Microbial Translocation Are Associated with Liver Fibrosis in Alcohol Use Disorder
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Daniel Fuster, Paola Zuluaga, Anna Hernández-Rubio, Alba Leis, Ferran Bolao, Oriol Farré, Inmaculada Rivas, Xavier Garcia-Calvo, and Robert Muga
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medicine.medical_specialty ,microbial translocation ,Lipopolysaccharide ,Inflammation ,Alcohol use disorder ,Comorbidity ,alcohol use disorder ,Article ,monocyte activation ,chemistry.chemical_compound ,Liver disease ,Comorbiditat ,Internal medicine ,mental disorders ,medicine ,liver fibrosis ,business.industry ,Monocyte ,Interleukin ,General Medicine ,Odds ratio ,medicine.disease ,Alcoholism ,medicine.anatomical_structure ,Endocrinology ,chemistry ,Quartile ,inflammation ,Alcoholisme ,Medicine ,medicine.symptom ,business - Abstract
Background: The association between markers of inflammation (interleukin (IL)-6 and IL-10), monocyte activation (sCD163 and sCD14), and microbial translocation (lipopolysaccharide (LPS) and LPS binding protein) and liver fibrosis in patients with alcohol use disorder (AUD) and no overt liver disease is not well established. Methods: We studied patients admitted for treatment of AUD at two hospitals in Barcelona. Advanced liver fibrosis (ALF) was defined as FIB-4 >, 3.25. Results: A total of 353 participants (76.3% male) were included and 94 (26.5%) had ALF. In adjusted correlation analyses, sCD163, sCD14, IL-6, IL-10, and LPS binding protein levels directly correlated with FIB-4 values (adjusted correlation coefficients 0.214, 0.452, 0.317, 0.204, and 0.171, respectively). However, LPS levels were inversely associated with FIB-4 (−0.283). All plasma marker levels in the highest quartile, except LPS, were associated with ALF (sCD163, sCD14, IL-6, IL-10, and LPS binding protein: adjusted odds ratio (aOR) 11.49 (95% confidence interval 6.42–20.56), 1.87 (1.11–3.16), 2.99 (1.79–5.01), 1.84 (1.11–3.16), and 2.13 (1.30–3.50), respectively). Conversely, LPS levels in the lowest quartile were associated with ALF (aOR 2.58 (1.48–4.58), p <, 0.01). Conclusion: In AUD patients, plasma levels of the markers of inflammation, monocyte activation, and microbial translocation are associated with ALF.
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- 2021
26. Informe sobre l’indicador de morbiditat: notificació de nous casos d'infecció pel VIH; any 2020
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Departament de Salut
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técnicas de investigación::métodos epidemiológicos::notificación de enfermedades [TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS] ,Catalonia ,Comorbiditat ,epidemiología y bioestadística::epidemiología::proceso salud-enfermedad::comorbilidad [SALUD PÚBLICA] ,virosis::infecciones por virus ARN::infecciones por Retroviridae::infecciones por Lentivirus::infecciones por VIH [ENFERMEDADES] ,Cataluña ,Virus Diseases::RNA Virus Infections::Retroviridae Infections::Lentivirus Infections::HIV Infections [DISEASES] ,Investigative Techniques::Epidemiologic Methods::Disease Notification [ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT] ,Epidemiology and Biostatistics::Epidemiology::Health-Disease Process::Comorbidity [PUBLIC HEALTH] ,Infeccions per VIH - Notificació - Catalunya - Abstract
Notificació; VIH; Virus de la immunodeficiència humana; Infecció Notificación; VIH; Virus de la inmunodeficiencia humana; Infección Notification; HIV; Human immunodeficiency virus; Infection L’objectiu d’aquest informe és conèixer l’evolució dels casos d’infecció pel virus de la immunodeficiència humana (VIH), ja siguin casos nous o diagnòstics de manera tardana tenint en compte la possible via de contagi.
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- 2021
27. Improved detection and management of advanced HIV disease through a community adult TB‐contact tracing intervention with same‐day provision of the WHO‐recommended package of care including ART initiation in a rural district of Mozambique
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Tom Chiller, Tacilta Nhampossa, Adrià Murias-Closas, Aina Casellas, Gregory S. Greene, Santiago Izco, Alberto L. García-Basteiro, Nteruma Catorze, Helio Chiconela, Emilio Letang, Belén Saavedra, Juan Ignacio García, Alexander Jordan, Alejandro Blanco-Arevalo, and Anna Febrer
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Adult ,Pediatrics ,medicine.medical_specialty ,Tuberculosis ,Adolescent ,TB-LAM ,Art initiation ,Population ,Psychological intervention ,HIV Infections ,Comorbidity ,World Health Organization ,Comorbiditat ,Intervention (counseling) ,medicine ,Humans ,TB contact-tracing ,education ,Research Articles ,Mozambique ,education.field_of_study ,Sub-Saharan Africa ,business.industry ,Public Health, Environmental and Occupational Health ,ART initiation ,Rural district ,CrAg ,medicine.disease ,AHD ,Infectious Diseases ,Infeccions per VIH ,TB contact‐tracing ,TB‐LAM ,Contact Tracing ,business ,sub‐Saharan Africa ,Contact tracing ,HIV infections ,Research Article ,Hiv disease - Abstract
Introduction AIDS‐mortality remains unacceptably high in sub‐Saharan Africa, largely driven by advanced HIV disease (AHD). We nested a study in an existing tuberculosis (TB) contact‐tracing intervention (Xpatial‐TB). The aim was to assess the burden of AHD among high‐risk people living with HIV (PLHIV) identified and to evaluate the provision of the WHO‐recommended package of care to this population. Methods All PLHIV ≥14 years old identified between June and December 2018 in Manhiça District by Xpatial‐TB were offered to participate in the study if ART naïve or had suboptimal ART adherence. Consenting individuals were screened for AHD. Patients with AHD (CD4
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- 2021
28. Periodontal disease as a predictor of chronic kidney disease (CKD) stage in older adults
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Rocío Violeta Valenzuela-Narváez, Oliver Gonzales-Aedo, Daniel Raùl Valenzuela-Narváez, Daniel Alberto Oswaldo Valenzuela-Narváez, Cris Lisseth Mejía-Ruiz, Medalit Nieves Salcedo-Rodríguez, and María Elena Córdova-Noel
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Medicine (General) ,medicine.medical_specialty ,hypertension ,kidney disease ,030232 urology & nephrology ,Malalties periodontals ,Comorbidity ,National Kidney Foundation Kidney Disease Outcomes Quality Initiative ,Biochemistry ,03 medical and health sciences ,R5-920 ,0302 clinical medicine ,Periodontal disease ,Comorbiditat ,Internal medicine ,Epidemiology ,Medicine ,Humans ,Stage (cooking) ,Renal Insufficiency, Chronic ,Periodontal Diseases ,Aged ,Kidney diseases ,business.industry ,Biochemistry (medical) ,030206 dentistry ,Cell Biology ,General Medicine ,medicine.disease ,Cross-Sectional Studies ,Malalties del ronyó ,epidemiology ,Periodontal Index ,business ,Community Periodontal Index of Treatment Needs ,Kidney disease ,Retrospective Clinical Research Report - Abstract
Objective The aim of this study was to evaluate periodontal disease as a predictor of chronic kidney disease (CKD) stage in older adults. Methods A total of 1159 adults aged 65 to 80 years and diagnosed with periodontal disease and CKD (stages 1, 2, and 3) were randomly selected for a cross-sectional study. Periodontal status was assessed using the Community Periodontal Index of Treatment Needs (CPITN) and CKD was staged using the National Kidney Foundation Kidney Disease Outcomes Quality Initiative (NKF-KDOQI) guidelines. Results In patients with stage 1 CKD, the odds ratios (ORs) (95% confidence intervals [CIs]) for CPITN-1, CPITN-2, CPITN-3, and CPITN-4 were 1.13 (0.83–1.55), 1.47 (1.13–1.81), 1, and 1, respectively. In patients with stage 2 CKD, the ORs (95% CIs) for CPITN-1, CPITN-2, CPITN-3, and CPITN-4 were 1.49 (1.14–1.93), 1.37 (1.02–1.78), 3.07 (2.81–3.25), and 3.65 (3.49–3.71), respectively. In patients with stage 3 CKD, the ORs (95% CIs) for CPITN-1, CPITN-2, CPITN-3, and CPITN-4 were 1, 1, 4.61 (4.47–5.21), and 5.23 (5.14–5.47), respectively. Conclusion The highest CPITN values (CPITN-3 and CPITN-4) were associated with CKD stages 2 and 3. Thus, periodontal disease may be associated with progression of CKD.
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- 2021
29. Behavioral addictions in bipolar disorders: A systematic review
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Esther Jiménez, Eduard Vieta, Brisa Solé, Laura Montejo, Estela Salagre, Iria Grande, André F. Carvalho, María Reinares, Brendon Stubbs, Anabel Martínez-Arán, C. Varo, Andrea Murru, and Universitat de Barcelona
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medicine.medical_specialty ,Bipolar Disorder ,Substance-Related Disorders ,media_common.quotation_subject ,Behavioral assessment ,Comorbidity ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Comorbiditat ,Randomized controlled trial ,law ,Humans ,Manic-depressive illness ,Medicine ,Pharmacology (medical) ,Bipolar disorder ,Anàlisi de conducta ,Psychiatry ,Biological Psychiatry ,media_common ,Pharmacology ,Trastorn bipolar ,Mood Disorders ,business.industry ,Addiction ,medicine.disease ,Anxiety Disorders ,030227 psychiatry ,Behavior, Addictive ,Substance abuse ,Psychiatry and Mental health ,Kleptomania ,Neurology ,Mood disorders ,Anxiety ,Neurology (clinical) ,medicine.symptom ,business ,030217 neurology & neurosurgery - Abstract
Clinical and epidemiological research suggests that behavioral addictions (BA) are associated with a wide range of psychiatric disorders. However, the relationship between BA and bipolar disorders (BD) has not been thoroughly explored. The aim of this systematic review was to critically summarize and evaluate the current available evidence regarding a possible association between BA and BD. A systematic review of major electronic databases according to PRISMA guidelines was conducted from inception to 31st December 2017. We sought quantitative studies data concerning prevalence of comorbidity, features and treatment related to BA-BD comorbidity. Data were narratively synthesized. Of the 1250 studies returned from the search, a total of 28 articles were included in this review. BA may be overrepresented in BD samples, and the other way around. Pathological gambling and kleptomania were the most prevalent conditions followed by compulsive buying, compulsive sexual behavior and internet addiction. BA was also associated with other mood disorders, anxiety disorders and substance use disorder. BD-BA comorbidity was related with more severe course of illness. Studies on treatment strategies for BD–BA comorbidity are rather limited; only one randomized controlled trial that fulfilled inclusion criteria was identified. Methodological heterogeneity in terms of design and results among studies was found. BD-BA commonly co-occurs although there is a need for rigorous studies. Routine screening and adequate assessment may be helpful in BD patients to identify individuals at risk for BA and to effectively manage the complex consequences associated with BA-BD comorbidity.
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- 2019
30. Impact of Individual Comorbidities on Survival of Patients with Myelofibrosis
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García-Fortes, María, Hernández-Boluda, Juan Carlos, Alvarez-Larrán, Alberto, Raya, José M., Angona Figueras, Anna, Estrada, Natalia, Fox, Laura, Cuevas, Beatriz, García-Hernández, María C., Gómez-Casares, Maria-Teresa, Ferrer-Marín, Francisca, Saavedra, Silvana, Cervantes, Francisco, García-Delgado, Regina, Grupo Español de Enfermedades Mieloproliferativas Filadelfia Negativas Gemfin, Institut Català de la Salut, [García-Fortes M] Hematology Department, Hospital Universitario Virgen de la Victoria, 29010 Málaga, Spain. Facultad de Medicina, Universidad de Málaga, 29010 Málaga, Spain. [Hernández-Boluda JC] Hematology Department, Hospital Clínico, INCLIVA, 46010 Valencia, Spain. [Álvarez-Larrán A] Hematology Department, Hospital Clínic, 08036 Barcelona, Spain. [Raya JM] Hematology Department, Hospital Universitario de Canarias, 38320 Santa Cruz de Tenerife, Spain. [Angona A] Hematology Department, Hospital del Mar, 08003 Barcelona, Spain. [Estrada N] Hematology Department, ICO-Hospital Germans Trias i Pujol, Josep Carreras Leukemia Research Institute, 08916 Badalona, Spain. [Fox L] Servei d’Hematologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain, and Vall d'Hebron Barcelona Hospital Campus
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Cancer Research ,Survival ,Myelofibrosis ,myelofibrosis ,Mielofibrosi - Prognosi ,Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Survival Analysis [ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT] ,comorbidities ,Prognosis ,survival ,Comorbidities ,técnicas de investigación::métodos epidemiológicos::estadística como asunto::análisis de supervivencia [TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS] ,Comorbiditat ,epidemiología y bioestadística::epidemiología::proceso salud-enfermedad::comorbilidad [SALUD PÚBLICA] ,Oncology ,Anàlisi de supervivència (Biometria) ,Hemic and Lymphatic Diseases::Hematologic Diseases::Bone Marrow Diseases::Myeloproliferative Disorders::Primary Myelofibrosis [DISEASES] ,enfermedades hematológicas y linfáticas::enfermedades hematológicas::enfermedades de la médula ósea::trastornos mieloproliferativos::mielofibrosis primaria [ENFERMEDADES] ,prognosis ,Epidemiology and Biostatistics::Epidemiology::Health-Disease Process::Comorbidity [PUBLIC HEALTH] - Abstract
Conflicts of Interest: M.G.-F. provided consultancy services to Pfizer, Novartis, Jazz Pharmaceuticals and Astellas. R.G.-D. provided consultancy services to Abbie, Novartis, Bristol-Myers Squibb, and Janssen, and received research funding from Bristol-Myers Squibb. F.F.-M. received a grant from Incyte Corporation (FFIS-CNT-2020-8) and from CTI Biophama Corp (CFE/BI/72-19; FFIS-CNT-2019-4). The remaining authors declare no competing financial interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results. Funding: This research was supported by an unrestricted grant from Novartis Pharmaceutical. The opinions expressed in this article are those of the authors and do not necessarily reflect those of Novartis. Acknowledgments: The authors thank all of the patients and their families who contributed to this study and the participating site study data coordinators. This article was produced through the collaborative efforts of the Spanish Group of Ph-negative Myeloproliferative Neoplasms (GEMFIN). The study was sponsored by Novartis Pharmaceuticals, Inc. The comorbidity burden is an important risk factor for overall survival (OS) in several hematological malignancies. This observational prospective study was conducted to evaluate the impact of individual comorbidities on survival in a multicenter series of 668 patients with primary myelofibrosis (PMF) or MF secondary to polycythemia vera (PPV-MF) or essential thrombocythemia (PET-MF). Hypertension (hazard ratio (HR) = 4.96, p < 0.001), smoking (HR = 5.08, p < 0.001), dyslipidemia (HR = 4.65, p < 0.001) and hepatitis C virus (HCV) (HR = 4.26, p = 0.015) were most adversely associated with OS. Diabetes (HR = 3.01, p < 0.001), pulmonary disease (HR = 3.13, p < 0.001) and renal dysfunction (HR = 1.82, p = 0.037) were also associated with an increased risk of death. Multivariate analysis showed that pulmonary disease (HR = 2.69, p = 0.001), smoking (HR = 3.34, p < 0.001), renal dysfunction (HR = 2.08, p = 0.043) and HCV (HR = 11.49, p = 0.001) had a negative impact on OS. When ruxolitinib exposure was included in the model, the effect of each comorbidity on survival was modified. Therefore, individual comorbidities should be taken into account in determining the survival prognosis for patients with MF.
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- 2022
31. Multimorbidity patterns in low-middle and high income regions: a multiregion latent class analysis using ATHLOS harmonised cohorts
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Universitat Politècnica de Catalunya. Departament d'Estadística i Investigació Operativa, Universitat Politècnica de Catalunya. GRBIO - Grup de Recerca en Bioestadística i Bioinformàtica, Bayés Marín, Ivet, Sánchez Niubó, Albert, Egea Cortés, Laia, Nguyen, Hai, Prina, Matthew, Fernández Martínez, Daniel, Haro, Josep Maria, Olaya, Beatriz, Universitat Politècnica de Catalunya. Departament d'Estadística i Investigació Operativa, Universitat Politècnica de Catalunya. GRBIO - Grup de Recerca en Bioestadística i Bioinformàtica, Bayés Marín, Ivet, Sánchez Niubó, Albert, Egea Cortés, Laia, Nguyen, Hai, Prina, Matthew, Fernández Martínez, Daniel, Haro, Josep Maria, and Olaya, Beatriz
- Abstract
Objectives: Our aim was to determine clusters of non-communicable diseases (NCDs) in a very large, population-based sample of middle-aged and older adults from low- and middle-income (LMICs) and high-income (HICs) regions. Additionally, we explored the associations with several covariates. Design: The total sample was 72¿140 people aged 50+ years from three population-based studies (English Longitudinal Study of Ageing, Survey of Health, Ageing and Retirement in Europe Study and Study on Global Ageing and Adult Health) included in the Ageing Trajectories of Health: Longitudinal Opportunities and Synergies (ATHLOS) project and representing eight regions with LMICs and HICs. Variables were previously harmonised using an ex-post strategy. Eight NCDs were used in latent class analysis. Multinomial models were made to calculate associations with covariates. All the analyses were stratified by age (50–64 and 65+ years¿old). Results Three clusters were identified: ‘cardio-metabolic’ (8.93% in participants aged 50–64 years and 27.22% in those aged 65+ years), ‘respiratory-mental-articular’ (3.91% and 5.27%) and ‘healthy’ (87.16% and 67.51%). In the younger group, Russia presented the highest prevalence of the ‘cardio-metabolic’ group (18.8%) and England the ‘respiratory-mental-articular’ (5.1%). In the older group, Russia had the highest proportion of both classes (48.3% and 9%). Both the younger and older African participants presented the highest proportion of the ‘healthy’ class. Older age, being woman, widowed and with low levels of education and income were related to an increased risk of multimorbidity. Physical activity was a protective factor in both age groups and smoking a risk factor for the ‘respiratory-mental-articular’. Conclusion: Multimorbidity is common worldwide, especially in HICs and Russia. Health policies in each country addressing coordination and support are needed to face the complexity of a pattern of growing multimorbidity., This work was supported by the 5-year Ageing Trajectories of Health: Longitudinal Opportunities and Synergies (ATHLOS) project and the Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM). The ATHLOS project has received funding from the European Union’s Horizon 2020 research and innovation programme under grant agreement No 635 316. DF’s work has been supported by grant RTI2018-100927-J-I00 Retos Investigación from Ministerio de Ciencia e Innovación (MCI), by Marsden grant E2987-3648 (Royal Society of New Zealand), and by grant 2017 SGR 622 (GRBIO) from the Departament d'Economia i Coneixement de la Generalitat de Catalunya (Spain). This work, grant number RTI2018-100927-J-I00, is supported by the Ministerio de Ciencia e Innovación (MCI, Spain), by the Agencia Estatal de Investigación (AEI, Spain) and by the European Regional Development Fund FEDER (FEDER, UE). BO’s work is supported by the PERIS programme 2016–2020 'Ajuts per a la Incorporació de Científics i Tecnòlegs' (grant number SLT006/17/00066), with the support of the Health Department from the Generalitat de Catalunya., Peer Reviewed, Postprint (published version)
- Published
- 2020
32. Envelliment, cronicitat i fragilitat en pacients amb infecció pel VIH
- Author
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EAP La Florida Sud, Institut Català de la Salut (ICS), Generalitat de Catalunya, Hospitalet de Llobregat, Spain. Grup de treball sobre VIH-sida de la Societat Catalana de Medicina Familiar i Comunitària (CAMFiC), Barcelona, Spain and Departament de Salut
- Subjects
Comorbiditat ,Otros calificadores::Otros calificadores::/tendencias [Otros calificadores] ,Infeccions per VIH - Pacients - Fragilitat ,calidad, acceso y evaluación de la atención sanitaria::calidad de la atención sanitaria::factores epidemiológicos::comorbilidad [ATENCIÓN DE SALUD] ,Persons::Survivors::HIV Long-Term Survivors [NAMED GROUPS] ,Infeccions per VIH - Pacients - Envelliment ,Health Care Quality, Access, and Evaluation::Quality of Health Care::Epidemiologic Factors::Comorbidity [HEALTH CARE] ,Personas::Sobrevivientes::Sobrevivientes de VIH a Largo Plazo [DENOMINACIONES DE GRUPOS] ,Other subheadings::Other subheadings::/trends [Other subheadings] ,Enfermedades del Sistema Inmune::Síndromes de Inmunodeficiencia::Infecciones por VIH [ENFERMEDADES] ,Immune System Diseases::Immunologic Deficiency Syndromes::HIV Infections [DISEASES] - Published
- 2021
33. Visual impairment in aging and cognitive decline: experience in a Memory Clinic
- Author
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Institut Català de la Salut, [Marquié M, Martínez J, Sánchez D] Centre de Recerca de l’Alzheimer i Clínica de la Memòria, Fundació ACE Institut Català de Neurociències Aplicades, Barcelona, Spain. Universitat Internacional de Catalunya (UIC), Barcelona, Spain. [Castilla-Martí M] Clínica Oftalmológica Dr. Castilla, Barcelona, Spain. Departament d’Oftalmologia, Hospital del Mar Barcelona, Spain. Departament d’Oftalmologia,Hospital de l'Esperança, Parc de Salut Mar, Barcelona, Spain. [Valero S, Hernández I] Centre de Recerca de l’Alzheimer i Clínica de la Memòria, Fundació ACE Institut Català de Neurociències Aplicades, Barcelona, Spain. Universitat Internacional de Catalunya (UIC), Barcelona, Spain. Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain. [Simó R, Ciudin A, Hernández C] Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain. Vall d’Hebron Institut de Recerca, Barcelona, Spain. Universitat Autònoma de Barcelona, Barcelona, Spain., and Hospital Universitari Vall d'Hebron
- Subjects
Other subheadings::/statistics & numerical data [Other subheadings] ,Comorbiditat ,Nervous System Diseases::Neurologic Manifestations::Sensation Disorders::Vision Disorders [DISEASES] ,Other subheadings::Other subheadings::/epidemiology [Other subheadings] ,Environment and Public Health::Public Health::Epidemiologic Factors::Comorbidity [HEALTH CARE] ,Mental Disorders::Neurocognitive Disorders::Cognition Disorders::Cognitive Dysfunction [PSYCHIATRY AND PSYCHOLOGY] ,Trastorns de la cognició en la vellesa - Epidemiologia ,Otros calificadores::Otros calificadores::/epidemiología [Otros calificadores] ,Otros calificadores::/estadística & datos numéricos [Otros calificadores] ,Trastorns de la visió - Epidemiologia ,Enfermedades del Sistema Nervioso::Manifestaciones Neurológicas::Trastornos de la Sensación::Trastornos de la Visión [ENFERMEDADES] ,ambiente y salud pública::salud pública::factores epidemiológicos::comorbilidad [ATENCIÓN DE SALUD] ,trastornos mentales::trastornos neurocognitivos::trastornos cognitivos::disfunción cognitiva [PSIQUIATRÍA Y PSICOLOGÍA] - Published
- 2021
34. Comorbidities at Diagnosis, Survival, and Cause of Death in Patients with Chronic Lymphocytic Leukemia: A Population-Based Study
- Author
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Villavicencio, Alicia, Solans, Marta, Zacarías-Pons, Lluís, Vidal, Anna, Puigdemont, Montse, Roncero, Josep Maria, Saez, Marc, Marcos-Gragera, Rafael, Universitat Autònoma de Barcelona, Institut Català de la Salut, [Villavicencio A] Epidemiology Unit and Girona Cancer Registry, Oncology Coordination Plan, Catalan Institute of Oncology, Girona, Spain. Research Group on Statistics, Econometrics and Health (GRECS), University of Girona, Girona, Spain. Descriptive Epidemiology, Genetics and Cancer Prevention Group, Biomedical Research Institute (IDIBGI), Girona, Spain. [Solans M] Research Group on Statistics, Econometrics and Health (GRECS), University of Girona, Girona, Spain. Descriptive Epidemiology, Genetics and Cancer Prevention Group, Biomedical Research Institute (IDIBGI), Girona, Spain. Centro de Investigación Biomédica en Red: Epidemiología y Salud Pública (CIBERESP), Madrid, Spain. [Zacarías-Pons Ll] Research Group on Aging, Disability and Health, Girona Biomedical Research Institute (IDIBGI), Girona, Spain. [Vidal A, Puigdemont M] Epidemiology Unit and Girona Cancer Registry, Oncology Coordination Plan, Catalan Institute of Oncology, Girona, Spain. Descriptive Epidemiology, Genetics and Cancer Prevention Group, Biomedical Research Institute (IDIBGI), Girona, Spain. [Roncero JM] Departament d’Hematologia, Hospital Universitari de Girona Doctor Josep Trueta, Institut Català de la Salut (ICS), Girona, Spain. [Saez M] Research Group on Statistics, Econometrics and Health (GRECS), University of Girona, Girona, Spain. Centro de Investigación Biomédica en Red: Epidemiología y Salud Pública (CIBERESP), Madrid, Spain. [Marcos-Gragera R] Epidemiology Unit and Girona Cancer Registry, Oncology Coordination Plan, Catalan Institute of Oncology, Girona, Spain. Research Group on Statistics, Econometrics and Health (GRECS), University of Girona, Girona, Spain. Descriptive Epidemiology, Genetics and Cancer Prevention Group, Biomedical Research Institute (IDIBGI), Girona, Spain. Centro de Investigación Biomédica en Red: Epidemiología y Salud Pública (CIBERESP), Madrid, Spain. Josep Carreras Leukemia Research Institute, Badalona, Spain, and Hospital Universitari de Girona Dr Josep Trueta
- Subjects
Multivariate analysis ,Other subheadings::Other subheadings::/epidemiology [Other subheadings] ,Health, Toxicology and Mutagenesis ,Chronic lymphocytic leukemia ,lcsh:Medicine ,Comorbidity ,0302 clinical medicine ,immune system diseases ,Cause of Death ,hemic and lymphatic diseases ,Medicine ,ambiente y salud pública::salud pública::factores epidemiológicos::comorbilidad [ATENCIÓN DE SALUD] ,Cause of death ,education.field_of_study ,Leucèmia limfoide ,Relative survival ,Otros calificadores::Otros calificadores::/epidemiología [Otros calificadores] ,Leucèmia limfoide - Epidemiologia ,Leucèmia limfoide -- Mortalitat ,030220 oncology & carcinogenesis ,neoplasias::neoplasias por tipo histológico::leucemia::leucemia linfoide::leucemia de células B::leucemia linfocítica crónica de células B [ENFERMEDADES] ,medicine.medical_specialty ,Population ,Mort - Causes ,causes of death ,comorbidities ,survival ,Article ,03 medical and health sciences ,Comorbiditat ,Diabetes mellitus ,Internal medicine ,Humans ,Health Care Quality, Access, and Evaluation::Quality of Health Care::Epidemiologic Factors::Comorbidity [HEALTH CARE] ,education ,Proportional Hazards Models ,business.industry ,lcsh:R ,Public Health, Environmental and Occupational Health ,medicine.disease ,Leukemia, Lymphocytic, Chronic, B-Cell ,Cancer registry ,population-based ,Lymphocytic leukemia ,Neoplasms::Neoplasms by Histologic Type::Leukemia::Leukemia, Lymphoid::Leukemia, B-Cell::Leukemia, Lymphocytic, Chronic, B-Cell [DISEASES] ,Investigative Techniques::Epidemiologic Methods::Data Collection::Vital Statistics::Mortality::Cause of Death [ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT] ,Lymphocytic leukemia -- Mortality ,Spain ,chronic lymphocytic leukemia ,business ,técnicas de investigación::métodos epidemiológicos::recopilación de datos::estadísticas vitales::mortalidad::causas de muerte [TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS] ,030215 immunology - Abstract
This study aimed to examine the prevalence of comorbidities in patients diagnosed with chronic lymphocytic leukemia (CLL), and to assess its influence on survival and cause-specific mortality at a population-based level. Incident CLL cases diagnosed in the Girona province (Spain) during 2008&ndash, 2016 were extracted from the Girona Cancer Registry. Rai stage and presence of comorbidities at diagnosis, further categorized using the Charlson comorbidity index (CCI), were obtained from clinical records. Observed (OS) and relative survival (RS) were estimated and Cox&rsquo, s proportional hazard models were used to explore the impact of comorbidity on mortality. Among the 400 cases included in the study, 380 (99.5%) presented at least one comorbidity at CLL diagnosis, with diabetes without end organ damage (21%) being the most common disease. 5-year OS and RS were 68.8 (95% CI: 64.4&ndash, 73.6) and 99.5 (95% CI 3.13&ndash, 106.0), respectively, which decreased markedly with increasing CCI, particularly in patients with CCI &ge, 3. Multivariate analysis identified no statistically significant association between the CCI and overall CLL-related or CLL-unrelated mortality. In conclusion, a high CCI score negatively influenced the OS and RS of CLL patients, yet its effect on mortality was statistically non-significant when also considering age and the Rai stage.
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- 2021
- Full Text
- View/download PDF
35. Perceived helpfulness of treatment for generalized anxiety disorder: a World Mental Health Surveys report
- Author
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Giovanni de Girolamo, Jacek Moskalewicz, Brendan Bunting, Dan J. Stein, Ronny Bruffaerts, Viviane Kovess-Masfety, Hannah N. Ziobrowski, Meredith Harris, Ronald C. Kessler, Sergio Aguilar-Gaxiola, Wai Tat Chiu, Fernando Navarro-Mateu, Aimee N. Karam, Miguel Xavier, Kate M. Scott, Maria Carmen Viana, Josep Maria Haro, Zahari Zarkov, María Elena Medina-Mora, Oye Gureje, Daisuke Nishi, Ayelet Meron Ruscio, Elie G. Karam, Nancy A. Sampson, Alan E. Kazdin, Louisa Degenhardt, Jordi Alonso, Ali Al-Hamzawi, Daniel Vigo, Jose Posada-Villa, Yasmin Altwaijri, Peter de Jonge, Sing Lee, Department of Psychiatry and Mental Health, Faculty of Health Sciences, and Developmental Psychology
- Subjects
medicine.medical_specialty ,Patient-centered outcomes ,Population ,RC435-571 ,Library science ,Comorbidity ,Anxiety ,Surveys ,Enquestes ,Generalized anxiety disorder ,Treatment helpfulness ,Comorbiditat ,Surveys and Questionnaires ,Prevalence ,medicine ,Humans ,education ,Health policy ,Psychiatry ,National Insurance ,education.field_of_study ,Public health ,Behavior disorders ,Health services research ,Pathways to treatment ,Anxiety Disorders ,Health Surveys ,Mental health ,Diagnostic and Statistical Manual of Mental Disorders ,Psychiatry and Mental health ,Ansietat ,National Comorbidity Survey ,Administration (government) ,Trastorns de la conducta ,Research Article - Abstract
Funding Information: The WHO World Mental Health Survey collaborators are Sergio Aguilar-Gaxiola, MD, PhD; Ali Al-Hamzawi, MD; Mohammed Salih Al-Kaisy, MD; Jordi Alonso, MD, PhD; Yasmin A. Altwaijri, PhD; Laura Helena Andrade, MD, PhD; Lukoye Atwoli, MD, PhD; Corina Benjet, PhD; Guilherme Borges, ScD; Evelyn J. Bromet, PhD; Ronny Bruffaerts, PhD; Brendan Bunting, PhD; Jose Miguel Caldas-de-Almeida, MD, PhD; Gra?a Cardoso, MD, PhD; Somnath Chatterji, MD; Alfredo H. Cia, MD; Louisa Degenhardt, PhD; Koen Demyttenaere, MD, PhD; Silvia Florescu, MD, PhD; Giovanni de Girolamo, MD; Oye Gureje, MD, DSc, FRCPsych; Josep Maria Haro, MD, PhD; Meredith G. Harris, PhD; Hristo Hinkov, MD, PhD; Chi-yi Hu, MD, PhD; Peter de Jonge, PhD; Aimee Nasser Karam, PhD; Elie G. Karam, MD; Norito Kawakami, MD, DMSc; Ronald C. Kessler, PhD; Andrzej Kiejna, MD, PhD; Viviane Kovess-Masfety, MD, PhD; Sing Lee, MBBS; Jean-Pierre Lepine, MD; John J. McGrath, MD, PhD; Maria Elena Medina-Mora, PhD; Zeina Mneimneh, PhD; Jacek Moskalewicz, PhD; Fernando Navarro-Mateu, MD, PhD; Marina Piazza, MPH, ScD; Jose Posada-Villa, MD; Kate M. Scott, PhD; Tim Slade, PhD; Juan Carlos Stagnaro, MD, PhD; Dan J. Stein, FRCPC, PhD; Margreet ten Have, PhD; Yolanda Torres, MPH, Dra.HC; Maria Carmen Viana, MD, PhD; Daniel V. Vigo, MD, DrPH; Harvey Whiteford, MBBS, PhD; David R. Williams, MPH, PhD; Bogdan Wojtyniak, ScD. Funding Information: The Argentina survey -- Estudio Argentino de Epidemiologia en Salud Mental (EASM) -- was supported by a grant from the Argentinian Ministry of Health (Ministerio de Salud de la Nacion) - (Grant Number 2002–17270/13–5). The 2007 Australian National Survey of Mental Health and Wellbeing is funded by the Australian Government Department of Health and Ageing. The Sao Paulo Megacity Mental Health Survey is supported by the State of Sao Paulo Research Foundation (FAPESP) Thematic Project Grant 03/00204–3. The Bulgarian Epidemiological Study of common mental disorders EPIBUL is supported by the Ministry of Health and the National Center for Public Health Protection. EPIBUL 2, conducted in 2016–17, is supported by the Ministry of Health and European Economic Area Grants. The Colombian National Study of Mental Health (NSMH) is supported by the Ministry of Social Protection. The Mental Health Study Medellin – Colombia was carried out and supported jointly by the Center for Excellence on Research in Mental Health (CES University) and the Secretary of Health of Medellin. The ESEMeD project is funded by the European Commission (Contracts QLG5–1999-01042; SANCO 2004123, and EAHC 20081308), (the Piedmont Region (Italy)), Fondo de Investigacion Sanitaria, Instituto de Salud Carlos III, Spain (FIS 00/0028), Ministerio de Ciencia y Tecnologia, Spain (SAF 2000–158-CE), Generalitat de Catalunya (2017 SGR 452; 2014 SGR 748), Instituto de Salud Carlos III (CIBER CB06/02/0046, RETICS RD06/0011 REM-TAP), and other local agencies and by an unrestricted educational grant from GlaxoSmithKline. Implementation of the Iraq Mental Health Survey (IMHS) and data entry were carried out by the staff of the Iraqi MOH and MOP with direct support from the Iraqi IMHS team with funding from both the Japanese and European Funds through United Nations Development Group Iraq Trust Fund (UNDG ITF). The Israel National Health Survey is funded by the Ministry of Health with support from the Israel National Institute for Health Policy and Health Services Research and the National Insurance Institute of Israel. The World Mental Health Japan (WMHJ) Survey is supported by the Grant for Research on Psychiatric and Neurological Diseases and Mental Health (H13-SHOGAI-023, H14-TOKUBETSU-026, H16-KOKORO-013, H25-SEISHIN-IPPAN-006) from the Japan Ministry of Health, Labour and Welfare. The Lebanese Evaluation of the Burden of Ailments and Needs Of the Nation (L.E.B.A.N.O.N.) is supported by the Lebanese Ministry of Public Health, the WHO (Lebanon), National Institute of Health/Fogarty International Center (R03 TW006481–01), anonymous private donations to IDRAAC, Lebanon, and unrestricted grants from, Algorithm, AstraZeneca, Benta, Bella Pharma, Eli Lilly, Glaxo Smith Kline, Lundbeck, Novartis, OmniPharma, Pfizer, Phenicia, Servier, UPO. The Mexican National Comorbidity Survey (MNCS) is supported by The National Institute of Psychiatry Ramon de la Fuente (INPRFMDIES 4280) and by the National Council on Science and Technology (CONACyT-G30544- H), with supplemental support from the Pan American Health Organization (PAHO). Te Rau Hinengaro: The New Zealand Mental Health Survey (NZMHS) is supported by the New Zealand Ministry of Health, Alcohol Advisory Council, and the Health Research Council. The Northern Ireland Study of Mental Health was funded by the Health & Social Care Research & Development Division of the Public Health Agency. The Peruvian World Mental Health Study was funded by the National Institute of Health of the Ministry of Health of Peru. The Polish project Epidemiology of Mental Health and Access to Care –EZOP Project (PL 0256) was carried out by the Institute of Psychiatry and Neurology in Warsaw in consortium with Department of Psychiatry - Medical University in Wroclaw and National Institute of Public Health-National Institute of Hygiene in Warsaw and in partnership with Psykiatrist Institut Vinderen–Universitet, Oslo. The project was funded by the European Economic Area Financial Mechanism and the Norwegian Financial Mechanism. EZOP project was co-financed by the Polish Ministry of Health. The Portuguese Mental Health Study was carried out by the Department of Mental Health, Faculty of Medical Sciences, NOVA University of Lisbon, with collaboration of the Portuguese Catholic University, and was funded by Champalimaud Foundation, Gulbenkian Foundation, Foundation for Science and Technology (FCT) and Ministry of Health. The Saudi National Mental Health Survey (SNMHS) is conducted by the King Salman Center for Disability Research. It is funded by Saudi Basic Industries Corporation (SABIC), King Abdulaziz City for Science and Technology (KACST), Ministry of Health (Saudi Arabia), and King Saud University. Funding in-kind was provided by King Faisal Specialist Hospital and Research Center, and the Ministry of Economy and Planning, General Authority for Statistics. The Psychiatric Enquiry to General Population in Southeast Spain – Murcia (PEGASUS-Murcia) Project has been financed by the Regional Health Authorities of Murcia (Servicio Murciano de Salud and Consejeria de Sanidad y Politica Social) and Fundacion para la Formacion e Investigacion Sanitarias (FFIS) of Murcia. The US National Comorbidity Survey Replication (NCS-R) is supported by the National Institute of Mental Health (NIMH; U01-MH60220) with supplemental support from the National Institute of Drug Abuse (NIDA), the Substance Abuse and Mental Health Services Administration (SAMHSA), the Robert Wood Johnson Foundation (RWJF; Grant 044708), and the John W. Alden Trust. Funding Information: The World Health Organization World Mental Health (WMH) Survey Initiative is supported by the United States National Institute of Mental Health (NIMH; R01 MH070884), the John D. and Catherine T. MacArthur Foundation, the Pfizer Foundation, the United States Public Health Service (R13-MH066849, R01-MH069864, and R01 DA016558), the Fogarty International Center (FIRCA R03-TW006481), the Pan American Health Organization, Eli Lilly and Company, Ortho-McNeil Pharmaceutical Inc., GlaxoSmithKline, and Bristol-Myers Squibb. We thank the staff of the WMH Data Collection and Data Analysis Coordination Centres for assistance with instrumentation, fieldwork, and consultation on data analysis. None of the funders had any role in the design, analysis, interpretation of results, or preparation of this paper. The views and opinions expressed in this report are those of the authors and should not be construed to represent the views of the World Health Organization, other sponsoring organizations, agencies, or governments. Funding Information: In the past 3 years, RCK reports being a consultant for Datastat, Inc., RallyPoint Networks, Inc., Sage Pharmaceuticals, and Takeda. FNM reports non-financial support from Otsuka outside and not related to the submitted work. In the past 3 years LD has received untied educational grant funding from Indivior and Seqirus, not related to the submitted work. DJS has received research grants and/or honoraria from Lundbeck, Johnson & Johnson, Servier and Takeda. The remaining authors declare that they have no competing interests. Publisher Copyright: © 2021, The Author(s).
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- 2021
36. The right to smoke and the right to smoke-free surroundings: international comparison of smoke-free psychiatric clinic implementation experiences
- Author
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Antoni Gual, Tove Freiburghaus, Rie Raffing, Hanne Tønnesen, and Montse Ballbè
- Subjects
medicine.medical_specialty ,media_common.quotation_subject ,carers ,Comorbidity ,human rights ,Investigació qualitativa ,03 medical and health sciences ,0302 clinical medicine ,Hàbit de fumar ,Comorbiditat ,Qualitative research ,medicine ,Human rights ,030212 general & internal medicine ,Psychiatry ,media_common ,in-patient treatment ,Smoke ,Smoking ,Smoking cessation intervention ,Addictions ,medicine.disease ,Psychiatric clinics ,030227 psychiatry ,Psychiatry and Mental health ,comorbidity ,Papers ,Life expectancy ,Drets humans ,Smoking ban ,Psychology - Abstract
Background In Scandinavia, people with a severe mental disorder have a reduced life expectancy of 15–20 years compared with the general public. Smoking is a major contributor, and smoke-free policies are increasingly adopted in psychiatric clinics around the world. We compared potential facilitators and barriers among staff and management, for the implementation of smoke-free psychiatric clinics. Aims To investigate the attitudes and experiences regarding smoke-free policies among managers and staff involved in the implementation processes of smoke-free psychiatric clinics at hospitals in Malmö (Sweden) and Barcelona (Spain). Method We used a qualitative methodology, with 15 semi-structured interviews. The interviews were conducted with each participant individually, and were subsequently transcribed. The data were analysed with systematic text condensation. Results There were notable differences in how the smoke-free policies were carried out and experienced, and attitudes regarding the policy changes differed in the two settings. Key differences were the views on the right to smoke in compulsory care and to stay in smoke-free surroundings supported by smoking cessation intervention; the prioritisation of staff facilitation of smoking breaks; and views on smoking and smoke-free psychiatry. In contrast, participants agreed on the importance of staff education and management support. A smoking ban by law and belonging to a network of smoke-free hospitals were also relevant. Conclusions Staff education, and support from staff and management for the patients’ right to stay in smoke-free surroundings, facilitated successful implementation of smoke-free policies in the psychiatric clinics, whereas supporting the right to smoke was a barrier.
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- 2021
37. Estudio de enfermedades crónicas de salud y funcionamiento en personas de mediana edad y mayores desde una perspectiva epidemiológica
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Bayés Marín, Ivet, Olaya Guzmán, Beatriz, Haro Abad, Josep Maria, and Universitat de Barcelona. Facultat de Medicina i Ciències de la Salut
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Public health ,Epidemiology ,Hábitos de salud ,Comorbidity ,Comorbilidad ,Salut pública ,Ciències de la Salut ,Population aging ,Hàbits sanitaris ,Envelliment de la població ,Comorbiditat ,Salud pública ,Epidemiología ,Epidemiologia ,Health behavior ,Envejecimiento de la población - Abstract
[spa] El incremento de la esperanza de vida suele traducirse en un mayor número de años vividos con discapacidad debido a una mayor prevalencia de enfermedades crónicas de salud. La multimorbilidad (MM) es cada vez más común y tiene consecuencias a varios niveles. Asimismo, funcionamiento físico y cognitivo están interrelacionados, pues las limitaciones físicas y el deterioro del estado cognitivo de la persona, consecuencia de la MM, repercuten en el curso y tratamiento de las enfermedades. El objetivo principal de esta tesis es lograr un mejor entendimiento de las enfermedades crónicas de salud y funcionamiento en población general de mediana edad (50-64) y mayores (65+) desde un punto de vista epidemiológico. La presente tesis analiza datos armonizados de diferentes estudios poblacionales sobre envejecimiento. El primer trabajo se identificaron tres clases latentes de MM, mediante análisis de clases latentes: “cardio-metabólica” (C-M), donde hubo una mayor prevalencia de diabetes, hipertensión, infarto de miocardio – angina de pecho y accidente cerebrovascular; “respiratoria- mental-articular” (R-M-A), caracterizada por mayores prevalencias de trastornos de las articulaciones, asma, EPOC y depresión; y clase “sana”, que se caracterizó por presentar prevalencias más bajas de enfermedades. Estas clases de MM fueron equivalentes en personas de mediana edad y mayores, así como en países con diferentes niveles de ingresos, aunque con diferentes proporciones. En el segundo trabajo se encontraron cuatro y tres trayectorias de memoria verbal distintas en ambos grupos de edad, mediante análisis de crecimiento de clases latentes en un periodo de seguimiento de 7 años. En general, aquellas trayectorias caracterizadas por un bajo rendimiento inicial y una mayor tasa de deterioro se asociaron a mayor edad, un nivel educativo inferior a educación primaria, un mayor número de enfermedades, así como a prevalencias más altas de diabetes, artritis, accidente cerebrovascular y depresión. Asimismo, estas trayectorias estuvieron asociadas a mayor discapacidad, peor calidad de vida y bajo nivel de actividad física. En el tercer trabajo se detectaron tres trayectorias paralelas de envejecimiento saludable en tres cohortes de nacimiento (≤1935, 1936-1945, >1945) basadas en la escala de salud funcional, física y cognitiva: “alto”, “medio” y “bajo” envejecimiento saludable. Tras ejecutar los modelos de regresión aditiva de Aalen, se observó que el riesgo de mortalidad en personas con enfermedad pulmonar obstructiva crónica (EPOC), sólo fue superior antes de ajustar por otras variables. Además aquellas personas clasificadas en trayectorias “alto” y “medio” tuvieron un mayor riesgo de mortalidad. Finalmente, la interacción entre EPOC y las trayectorias solo fue significativa en la cohorte ≤1935. En este caso, aquellas personas con EPOC y clasificadas en el grupo “bajo” tuvieron un mayor riesgo de mortalidad. El conjunto de los resultados confirman que las enfermedades tienden a agruparse en forma de patrones de MM y que estas agrupaciones son comunes entre los grupos de edad estudiados y entre regiones. Del mismo modo, la presencia de enfermedades y MM está asociada a un peor desempeño cognitivo, así como a un deterioro funcional más pronunciado. Dentro de las mejoras en la atención al paciente con múltiples condiciones de salud, debería ser incluida la evaluación de la capacidad funcional de la persona, considerando la capacidad intrínseca del individuo, es decir, sus capacidades físicas y mentales, y las facilidades y limitaciones del entorno, como el acceso a medicación, soporte y barreras funcionales., [eng] Increased life expectancy, together with changes in lifestyles or environmental exposures have contributed to increase the prevalence of chronic health conditions. As a consequence, multimorbidity (MM) and dementia are increasingly common and have multiple consequences. Furthermore, physical and cognitive functioning are interrelated, as the physical limitations and deterioration of a person's cognitive status as a consequence of MM have an impact on the course and treatment of diseases, which aggravates and increases the risk of MM. It is therefore essential to take into account the functional status of the person in interaction with chronic health conditions and cognitive difficulties, promoting healthy ageing. The present thesis analyses harmonised data from different population-based cohort studies on ageing, in order to achieve a better understanding of non-communicable diseases and functioning (healthy ageing) in a sample of middle-aged (50-64) and older (65+) individuals. Taken together, the results confirm that diseases tend to cluster in the form of MM patterns and that these clusters are common across the age groups studied and across regions. Similarly, the presence of disease and MM is associated with worse cognitive performance, as well as more pronounced functional impairment. Within the improvements in the care of the patient with multiple health conditions, the assessment of the functional capacity of the person should be included, considering the intrinsic capacity of the individual, that is, his or her physical and mental abilities, and the facilities and limitations of the environment, such as access to medication, support and functional barriers.
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- 2021
38. Structural brain correlates in major depression, anxiety disorders and post-traumatic stress disorder: A voxel-based morphometry meta-analysis
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Carles Soriano-Mas, Sevdalina Kandilarova, Kevin Hilbert, David Mataix-Cols, Alba Gómez-Benlloch, Daniel Porta-Casteràs, Marta Carulla-Roig, Narcís Cardoner, Eduard Vieta, Esther Via, Eric J. Canales-Rodríguez, Yuqui Cheng, Paul Klauser, Joaquim Radua, Toby Wise, Danilo Arnone, M. Serra-Blasco, and Anton Albajes-Eizagirre
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Meta-analysis ,Comorbidity ,Neuropsychiatry ,Stress Disorders, Post-Traumatic ,Behavioral Neuroscience ,Medicine ,Gray Matter ,gray matter volume ,panic disorder ,structural neuroimaging ,Depression ,Traumatic stress ,Brain ,Magnetic Resonance Imaging ,Comorbidities ,anterior cingulate cortex ,Neuropsychology and Physiological Psychology ,medicine.anatomical_structure ,posttraumatic stress disorder ,neurphyiatry ,Anxiety ,Major depressive disorder ,abnormalities ,Anxiety disorders ,medicine.symptom ,Clinical psychology ,Psychology, Pathological ,emotion regulation ,Cognitive Neuroscience ,hippocampal volume ,Grey matter ,comorbidities ,behavioral disciplines and activities ,anxiety disorders ,Comorbiditat ,mental disorders ,drug-naive ,Humans ,unipolar depression ,Structural neuroimaging ,Depressive Disorder, Major ,major depressive disorder ,medication-naive patients ,business.industry ,Gray matter volume ,Posttraumatic stress disorder ,Voxel-based morphometry ,medicine.disease ,Psicopatologia ,meta-analysis ,gray-matter volume ,orbitofrontal cortex ,business - Abstract
The high comorbidity of Major Depressive Disorder (MDD), Anxiety Disorders (ANX), and Posttraumatic Stress Disorder (PTSD) has hindered the study of their structural neural correlates. The authors analyzed specific and common grey matter volume (GMV) characteristics by comparing them with healthy controls (HC). The meta-analysis of voxel-based morphometry (VBM) studies showed unique GMV diminutions for each disorder (p < 0.05, corrected) and less robust smaller GMV across diagnostics (p < 0.01, uncorrected). Pairwise comparison between the disorders showed GMV differences in MDD versus ANX and in ANX versus PTSD. These results endorse the hypothesis that unique clinical features characterizing MDD, ANX, and PTSD are also reflected by disorder specific GMV correlates.
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- 2021
39. Food biodiversity and total and cause-specific mortality in 9 European countries:An analysis of a prospective cohort study
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Kris A. Murray, Stina Ramne, Carl Lachat, Jytte Halkjær, Giovanna Masala, H. Bas Bueno-de-Mesquita, Stina Bodén, Torkjel M. Sandanger, Christina C. Dahm, Matthias B. Schulze, Pietro Ferrari, Heinz Freisling, Marc J. Gunter, Paula Jakszyn, Paolo Vineis, Franziska Jannasch, Miguel Rodríguez-Barranco, Yvonne T. van der Schouw, Eva Ardanaz, Andrew D. Jones, Inge Huybrechts, Verena Katzke, Gina Kennedy, Konstantinos K. Tsilidis, Salvatore Panico, Mathilde Touvier, Lluís Cirera, Ingegerd Johansson, Anne Tjønneland, Roseline Remans, Christopher Millett, Elisabete Weiderpass, Elio Riboli, Rosario Tumino, Giles Hanley-Cook, Geneviève Nicolas, Carine Biessy, Mélanie Deschasaux-Tanguy, Carlotta Sacerdote, Alemayehu Argaw, Bernard Srour, Guri Skeie, Emmanuelle Kesse-Guyot, Corinne Casagrande, Daniel B Ibsen, and Giuliana Gargano
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Male ,Mediterranean diet ,DIVERSITY ,Comorbidity ,GUIDELINES ,Geographical Locations ,Cause of Death ,Medicine and Health Sciences ,Medicine ,Prospective Studies ,Prospective cohort study ,11 Medical and Health Sciences ,RISK ,Nutrition and Dietetics ,Ecology ,Mortality rate ,Hazard ratio ,General Medicine ,Biodiversity ,Middle Aged ,Micronutrient ,CANCER ,European Prospective Investigation into Cancer and Nutrition ,Näringslära ,MEDITERRANEAN DIET ,Europe ,Oncology ,Cohort ,Marital status ,Female ,HEALTH ,Life Sciences & Biomedicine ,Research Article ,Adult ,Ecological Metrics ,Death Rates ,ENVIRONMENTAL IMPACTS ,Beverages ,Medicine, General & Internal ,Comorbiditat ,Population Metrics ,General & Internal Medicine ,Humans ,CORONARY-HEART-DISEASE ,Mortality ,Nutrició ,Proportional Hazards Models ,Nutrition ,Science & Technology ,Population Biology ,business.industry ,Ecology and Environmental Sciences ,Biology and Life Sciences ,Cancers and Neoplasms ,CONSUMPTION ,Species Diversity ,Biodiversitat ,Diet ,Food ,Multivariate Analysis ,People and Places ,business ,Demography - Abstract
Background Food biodiversity, encompassing the variety of plants, animals, and other organisms consumed as food and drink, has intrinsic potential to underpin diverse, nutritious diets and improve Earth system resilience. Dietary species richness (DSR), which is recommended as a crosscutting measure of food biodiversity, has been positively associated with the micronutrient adequacy of diets in women and young children in low- and middle-income countries (LMICs). However, the relationships between DSR and major health outcomes have yet to be assessed in any population. Methods and findings We examined the associations between DSR and subsequent total and cause-specific mortality among 451,390 adults enrolled in the European Prospective Investigation into Cancer and Nutrition (EPIC) study (1992 to 2014, median follow-up: 17 years), free of cancer, diabetes, heart attack, or stroke at baseline. Usual dietary intakes were assessed at recruitment with country-specific dietary questionnaires (DQs). DSR of an individual’s yearly diet was calculated based on the absolute number of unique biological species in each (composite) food and drink. Associations were assessed by fitting multivariable-adjusted Cox proportional hazards regression models. In the EPIC cohort, 2 crops (common wheat and potato) and 2 animal species (cow and pig) accounted for approximately 45% of self-reported total dietary energy intake [median (P10–P90): 68 (40 to 83) species consumed per year]. Overall, higher DSR was inversely associated with all-cause mortality rate. Hazard ratios (HRs) and 95% confidence intervals (CIs) comparing total mortality in the second, third, fourth, and fifth (highest) quintiles (Qs) of DSR to the first (lowest) Q indicate significant inverse associations, after stratification by sex, age, and study center and adjustment for smoking status, educational level, marital status, physical activity, alcohol intake, and total energy intake, Mediterranean diet score, red and processed meat intake, and fiber intake [HR (95% CI): 0.91 (0.88 to 0.94), 0.80 (0.76 to 0.83), 0.69 (0.66 to 0.72), and 0.63 (0.59 to 0.66), respectively; PWald < 0.001 for trend]. Absolute death rates among participants in the highest and lowest fifth of DSR were 65.4 and 69.3 cases/10,000 person-years, respectively. Significant inverse associations were also observed between DSR and deaths due to cancer, heart disease, digestive disease, and respiratory disease. An important study limitation is that our findings were based on an observational cohort using self-reported dietary data obtained through single baseline food frequency questionnaires (FFQs); thus, exposure misclassification and residual confounding cannot be ruled out. Conclusions In this large Pan-European cohort, higher DSR was inversely associated with total and cause-specific mortality, independent of sociodemographic, lifestyle, and other known dietary risk factors. Our findings support the potential of food (species) biodiversity as a guiding principle of sustainable dietary recommendations and food-based dietary guidelines., Dr. Giles T. Hanley-Cook and colleagues, analyzed data from a prospective cohort study to investigate the association between food biodiversity, and total and cause-specific mortality in nine European countries., Author summary Why was this study done? Facilitating populations to transition to diets that are both nutritious and sustainable is a key challenge for human and environmental health. Dietary (between food group) diversity is increasingly advocated within the framework of dietary recommendations and food-based dietary guidelines. Food biodiversity, defined as the variety of plants, animals, and other organisms that are consumed between and within food groups globally, is a potential lever for improved public and planetary health. Nevertheless, scientific evidence is a prerequisite to understand the associations between metrics of food biodiversity and major health outcomes. Thus far, evidence regarding the positive association between dietary species richness (DSR), i.e., the absolute number of unique species consumed by an individual, and micronutrient adequacy of diets is limited to low- and middle-income countries (LMICs). What did the researchers do and find? This study assessed the relationships between DSR and all-cause and cause-specific mortality in the large and diverse European population that constitutes the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort, including 451,390 adults from 9 European countries with 46,627 recorded deaths between 1992 and 2014. In addition, this study provides a picture of the usual consumption of food and beverage species across 9 European countries. Higher DSR was inversely associated with total mortality rate and cause-specific deaths due to cancer, heart disease, respiratory disease, and digestive disease, independent of other established components of diet quality. Overall, self-reported total energy intake was derived from a narrow range of species. What do these findings mean? Our findings add to the evidence base on the relevance of food biodiversity, both between and within food groups, as a basis for public health strategies championing dietary (species) diversity in European countries. These findings will play a key role in communications about the merits of biodiversity stewardship, in the context of ongoing European/global debate on nutritious and sustainable diets for a stable Earth system.
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- 2021
40. Disrupted Mitochondrial and Metabolic Plasticity Underlie Comorbidity Between Age-related and Degenerative Disorders as Parkinson Disease and Type 2 Diabetes Mellitus
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Carmen García-Ruiz, Aida Ormazabal, Francesc Cardellach, Josep Maria Grau, Francesc Valldeoriola, Rafael Artuch, Constanza Morén, Ingrid González-Casacuberta, Rubén Fernández-Santiago, Mario Ezquerra, José C. Fernández-Checa, Glòria Garrabou, Ester Tobías, Joan de la Torre-Lara, Esteban Muñoz, Eduardo Tolosa, Mercedes Casado, Diana Luz Juárez-Flores, Mariona Guitart-Mampel, Francesc Josep García-García, Yaroslau Compta, María José Martí, Raquel Fucho, Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red Enfermedades Raras (España), European Commission, Fundació Privada Cellex, Generalitat de Catalunya, Ministerio de Ciencia, Innovación y Universidades (España), Agencia Estatal de Investigación (España), Ministerio de Economía y Competitividad (España), Garrabou, Glòria [0000-0001-8973-9933], and Garrabou, Glòria
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0301 basic medicine ,medicine.medical_specialty ,Arginine ,Physiology ,Parkinson's disease ,Clinical Biochemistry ,Oxidative phosphorylation ,Comorbidity ,Mitochondrion ,Biochemistry ,Article ,Mitocondris ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Comorbiditat ,Internal medicine ,Malaltia de Parkinson ,Metabolome ,Medicine ,iPD (idiopathic Parkinson’s disease) ,Molecular Biology ,Diabetis ,business.industry ,Diabetes ,lcsh:RM1-950 ,Glutamate receptor ,Type 2 Diabetes Mellitus ,Cell Biology ,Metabolism ,Ornithine ,bacterial infections and mycoses ,nervous system diseases ,T2DM (type 2 diabetes mellitus) ,Mitochondria ,mitochondria ,030104 developmental biology ,Endocrinology ,lcsh:Therapeutics. Pharmacology ,chemistry ,metabolome ,business ,030217 neurology & neurosurgery - Abstract
Idiopathic Parkinson’s disease (iPD) and type 2 diabetes mellitus (T2DM) are chronic, multisystemic, and degenerative diseases associated with aging, with eventual epidemiological co-morbidity and overlap in molecular basis. This study aims to explore if metabolic and mitochondrial alterations underlie the previously reported epidemiologic and clinical co-morbidity from a molecular level. To evaluate the adaptation of iPD to a simulated pre-diabetogenic state, we exposed primary cultured fibroblasts from iPD patients and controls to standard (5 mM) and high (25 mM) glucose concentrations to further characterize metabolic and mitochondrial resilience. iPD fibroblasts showed increased organic and amino acid levels related to mitochondrial metabolism with respect to controls, and these differences were enhanced in high glucose conditions (citric, suberic, and sebacic acids levels increased, as well as alanine, glutamate, aspartate, arginine, and ornithine amino acids; p-values between 0.001 and 0.05). The accumulation of metabolites in iPD fibroblasts was associated with (and probably due to) the concomitant mitochondrial dysfunction observed at enzymatic, oxidative, respiratory, and morphologic level. Metabolic and mitochondrial plasticity of controls was not observed in iPD fibroblasts, which were unable to adapt to different glucose conditions. Impaired metabolism and mitochondrial activity in iPD may limit energy supply for cell survival. Moreover, reduced capacity to adapt to disrupted glucose balance characteristic of T2DM may underlay the co-morbidity between both diseases. Conclusions: Fibroblasts from iPD patients showed mitochondrial impairment, resulting in the accumulation of organic and amino acids related to mitochondrial metabolism, especially when exposed to high glucose. Mitochondrial and metabolic defects down warding cell plasticity to adapt to changing glucose bioavailability may explain the comorbidity between iPD and T2DM., This work was supported by funds from the Integrated Projects of Excellence PIE14/00061 and the Fondo de Investigaciones Sanitarias of the Instituto de Salud Carlos III (ISCIII) (grant numbers PI1800498 and PI1800451), the Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), all initiatives of ISCIII and FEDER (‘Una manera de hacer Europa’), as well as Fundació Privada Cellex and Suports a Grups de Recerca (grant code 2017 SGR 893) and CERCA programs from the Generalitat de Catalunya. Maria de Maeztu Unit of Excellence funded our institution (Institute of Neurosciences, University of Barcelona) as consolidated excellence centre (MDM-2017-0729, Ministry of Science, Innovation and Universities). Two grants from the Spanish government allowed facility maintenance (SAF2017-85877-R from CGR and both SAF2015-69944-R and PID2019-111669RB-I00 from JCFC)
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- 2020
41. Relationship of adverse events to quality of anticoagulation control in atrial fibrillation patients with diabetes: Real-world data from the FANTASIIA registry
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Javier Muñiz, Inmaculada Roldán-Rabadán, Martín Ruiz Ortiz, Francisco Marín, Amaya García-Fernández, Manuel Anguita, Gregory Y.H. Lip, Vicente Bertomeu-Martínez, Lina Badimon, María Asunción Esteve-Pastor, Angel Cequier, Déborah Otero, and Fantasiia Study Investigators
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Male ,medicine.medical_specialty ,Adverse outcomes ,media_common.quotation_subject ,Oral anticoagulation ,Comorbidity ,030204 cardiovascular system & hematology ,03 medical and health sciences ,0302 clinical medicine ,Diabetes mellitus ,Comorbiditat ,Atrial Fibrillation ,medicine ,Fibril·lació auricular ,Diabetes Mellitus ,Humans ,Quality (business) ,030212 general & internal medicine ,Prospective Studies ,Registries ,Adverse effect ,media_common ,Aged ,Aged, 80 and over ,Diabetis ,business.industry ,Diabetes ,Anticoagulants ,Atrial fibrillation ,General Medicine ,Original Articles ,Middle Aged ,medicine.disease ,Risk factors ,Case-Control Studies ,Emergency medicine ,Female ,business ,Real world data ,Factor Xa Inhibitors - Abstract
BACKGROUND:Atrial fibrillation (AF) patients with diabetes (DM) are at increased risk of cardiovascular events and have higher related morbidity and mortality. PURPOSE:To compare clinical characteristics, cardiovascular adverse outcomes and quality of anticoagulation in AF patients with and without DM. METHODS:AF patients from the Spanish national, multicentric, prospective FANTASIIA registry were included. Patients received oral anticoagulation (vitamin K antagonists (VKA) or direct oral anticoagulants (DOAC)) for at least 6 months before inclusion. Baseline clinical characteristics and comorbidities were recorded. After 2-years follow-up, the association between adverse events and the presence of DM was evaluated. RESULTS:1956 individuals (mean age 73.8 ± 9.5 years, 56% male) were analysed; of these, 574 (29.3%) had DM. Diabetic patients had increased prevalence of other risk factors such as hypertension (90.6% vs 76.1%; p
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- 2020
42. The Effects of Escalation of Respiratory Support and Prolonged Invasive Ventilation on Outcomes of Cardiac Surgical Patients: A Retrospective Cohort Study
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Caroline Gerrard, Marc Giménez-Milà, Andrew Conway Morris, Ken Kuljit S. Parhar, Alain Vuylsteke, Vasileios Zochios, Andrew A. Klein, Joht Singh Chandan, Marcus J. Schultz, Intensive Care Medicine, ACS - Diabetes & metabolism, ACS - Pulmonary hypertension & thrombosis, ACS - Microcirculation, Conway Morris, Andrew [0000-0002-3211-3216], and Apollo - University of Cambridge Repository
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medicine.medical_specialty ,medicine.medical_treatment ,Comorbidity ,030204 cardiovascular system & hematology ,Respiració artificial ,Hypoxemia ,law.invention ,Cohort Studies ,03 medical and health sciences ,0302 clinical medicine ,Comorbiditat ,030202 anesthesiology ,law ,invasive ventilation ,medicine ,Clinical endpoint ,Humans ,Continuous positive airway pressure ,Cardiac Surgical Procedures ,Retrospective Studies ,Noninvasive Ventilation ,business.industry ,Retrospective cohort study ,Perioperative ,pulmonary morbidity ,Length of Stay ,Respiration, Artificial ,Intensive care unit ,Cardiac surgery ,Heart surgery ,Anesthesiology and Pain Medicine ,Artificial respiration ,Emergency medicine ,Breathing ,Cirurgia cardíaca ,postoperative pulmonary complications ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business ,cardiac surgery - Abstract
Objectives: The aim of this study was to determine the effects of escalation of respiratory support and prolonged postoperative invasive ventilation on patient–centered outcomes, and identify perioperative factors associated with these two respiratory complications. Design: A retrospective cohort analysis of cardiac surgical patients admitted to cardiothoracic intensive care unit (ICU) between August 2015 and January 2018. Escalation of respiratory support was defined as ‘unplanned continuous positive airway pressure’, ‘non-invasive ventilation’ or ‘reintubation’ following surgery; prolonged invasive ventilation was defined as ‘invasive ventilation beyond the first 12 hours following surgery’. The primary endpoint was the composite of escalation of respiratory support and prolonged ventilation. Setting: Tertiary cardiothoracic ICU. Participants: A total of 2,098 patients were included and analyzed. Interventions: None. Measurements and Main Results: The composite of escalation of support or prolonged ventilation occurred in 509 patients (24.3%). Patients who met the composite had higher mortality (2.9% vs 0.1%; P, ACM is supported by a Clinical Research Career Development Fellowship from the Wellcome Trust (WT 2055214/Z/16/Z). VZ is supported by an Academic Clinical Fellowship from the National Institute for Health Research (ACF-2016-09-011).
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- 2020
43. Performance of comprehensive risk adjustment for the prediction of in-hospital events using administrative healthcare data: The queralt indices
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Monterde, David, Cainzos-Achirica, Miguel, Cossio-Gil, Yolima, García-Eroles, Luis, Pérez-Sust, Pol, Arrufat, Miquel, Calle, Candela, Comin-Colet, Josep, and Velasco, César
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Risk Management and Healthcare Policy ,Administració sanitària ,Health services administration ,multimorbidity ,Comorbidity ,case-mix ,Hospitals ,comorbidity ,Comorbiditat ,benchmarking ,Original Research ,discrimination ,Queralt’s indices ,risk - Abstract
Background Accurate risk adjustment is crucial for healthcare management and benchmarking. Purpose We aimed to compare the performance of classic comorbidity functions (Charlson’s and Elixhauser’s), of the All Patients Refined Diagnosis Related Groups (APR-DRG), and of the Queralt Indices, a family of novel, comprehensive comorbidity indices for the prediction of key clinical outcomes in hospitalized patients. Material and Methods We conducted an observational, retrospective cohort study using administrative healthcare data from 156,459 hospital discharges in Catalonia (Spain) during 2018. Study outcomes were in-hospital death, long hospital stay, and intensive care unit (ICU) stay. We evaluated the performance of the following indices: Charlson’s and Elixhauser’s functions, Queralt’s Index for secondary hospital discharge diagnoses (Queralt DxS), the overall Queralt’s Index, which includes pre-existing comorbidities, in-hospital complications, and principal discharge diagnosis (Queralt Dx), and the APR-DRG. Discriminative ability was evaluated using the area under the curve (AUC), and measures of goodness of fit were also computed. Subgroup analyses were conducted by principal discharge diagnosis, by age, and type of admission. Results Queralt DxS provided relevant risk adjustment information in a larger number of patients compared to Charlson’s and Elixhauser’s functions, and outperformed both for the prediction of the 3 study outcomes. Queralt Dx also outperformed Charlson’s and Elixhauser’s indices, and yielded superior predictive ability and goodness of fit compared to APR-DRG (AUC for in-hospital death 0.95 for Queralt Dx, 0.77–0.93 for all other indices; for ICU stay 0.84 for Queralt Dx, 0.73–0.83 for all other indices). The performance of Queralt DxS was at least as good as that of the APR-DRG in most principal discharge diagnosis subgroups. Conclusion Our findings suggest that risk adjustment should go beyond pre-existing comorbidities and include principal discharge diagnoses and in-hospital complications. Validation of comprehensive risk adjustment tools such as the Queralt indices in other settings is needed., Video abstract Point your SmartPhone at the code above. If you have a QR code reader the video abstract will appear. Or use: https://youtu.be/bUzPgB1KMRg
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- 2020
44. Evaluación de las características clínicas y evolución de pacientes con COVID-19 a partir de una serie de 1000 pacientes atendidos en servicios de urgencias españoles
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Gil-Rodrigo, Adriana, Miro, Oscar, Pinera, Pascual, Burillo-Putze, Guillermo, Jimenez, Sonia, ALFONSO MARTÍN MARTÍNEZ, Javier Martin-Sanchez, Francisco, Jacob, Javier, Maria Guardiola, Josep, Jorge Garcia-Lamberechts, Eric, Espinosa, Begona, Martin Mojarro, Enrique, Gonzalez Tejera, Matilde, Serrano, Leticia, Aguera, Carmen, Soy, Ester, Llauger, Lluis, Angeles Juan, Maria, Palau, Anna, Del Arco, Carmen, Rodriguez Miranda, Belen, Maza Vera, Maria Teresa, Martin Quiros, Alejandro, Tejada Los Santos, Laura, Ruiz Lobera, Noemi, Iglesias Vela, Marta, Torres Garate, Raquel, Alquezar-Arbe, Aitor, Gonzalez Del Castillo, Juan, and Llorens, Pere
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Adult ,Male ,Adolescent ,Emergency health services ,Pneumonia, Viral ,Comorbidity ,Betacoronavirus ,Young Adult ,Age Distribution ,Comorbiditat ,Neoplasms ,Intubation, Intratracheal ,Odds Ratio ,Humans ,Hospital Mortality ,Obesity ,Prospective Studies ,Sex Distribution ,Child ,Pandemics ,Aged ,Aged, 80 and over ,Clinical characteristics ,SARS-CoV-2 ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,Age Factors ,Infant, Newborn ,Infant ,COVID-19 ,Middle Aged ,Prognosis ,Respiration Disorders ,Respiration, Artificial ,Serveis d'urgències hospitalàries ,Coronavirus disease 2019 (COVID-19) ,Logistic Models ,Cardiovascular Diseases ,Spain ,Child, Preschool ,Hospital emergency services ,Female ,Symptom Assessment ,Coronavirus Infections ,Emergency Service, Hospital - Abstract
To describe the clinical characteristics of patients with coronavirus disease 2019 (COVID-19) treated in hospital emergency departments (EDs) in Spain, and to assess associations between characteristics and outcomes.Prospective, multicenter, nested-cohort study. Sixty-one EDs included a random sample of all patients diagnosed with COVID-19 between March 1 and April 30, 2020. Demographic and baseline health information, including concomitant conditions; clinical characteristics related to the ED visit and complementary test results; and treatments were recorded throughout the episode in the ED. We calculated crude and adjusted odds ratios for risk of in-hospital death and a composite outcome consisting of the following events: intensive care unit admission, orotracheal intubation or mechanical ventilation, or in-hospital death. The logistic regression models were constructed with 3 groups of independent variables: the demographic and baseline health characteristics, clinical characteristics and complementary test results related to the ED episode, and treatments.The mean (SD) age of patients was 62 (18) years. Most had high- or low-grade fever, dry cough, dyspnea, and diarrhea. The most common concomitant conditions were cardiovascular diseases, followed by respiratory diseases and cancer. Baseline patient characteristics that showed a direct and independent association with worse outcome (death and the composite outcome) were age and obesity. Clinical variables directly associated with worse outcomes were impaired consciousness and pulmonary crackles; headache was inversely associated with worse outcomes. Complementary test findings that were directly associated with outcomes were bilateral lung infiltrates, lymphopenia, a high platelet count, a D-dimer concentration over 500 mg/dL, and a lactate-dehydrogenase concentration over 250 IU/L in blood.This profile of the clinical characteristics and comorbidity of patients with COVID-19 treated in EDs helps us predict outcomes and identify cases at risk of exacerbation. The information can facilitate preventive measures and improve outcomes.Describir las características clínicas de los pacientes con COVID-19 atendidos en los servicios de urgencias hospitalarios (SUH) españoles y evaluar su asociación con los resultados de su evolución.Estudio multicéntrico, anidado en una cohorte prospectiva. Participaron 61 SUH que incluyeron pacientes seleccionados aleatoriamente de todos los diagnosticados de COVID-19 entre el 1 de marzo y el 30 de abril de 2020. Se recogieron características basales, clínicas, de exploraciones complementarias y terapéuticas del episodio en los SUH. Se calcularon las odds ratio (OR) asociadas a la mortalidad intrahospitalaria y al evento combinado formado por el ingreso en unidad de cuidados intensivos (UCI), la intubación orotraqueal o ventilación mecánica invasiva (IOT/ VMI), crudas y ajustadas con modelos de regresión logística para tres grupos de variables independientes: basales, clínicas y de exploraciones complementarias.La edad media fue de 62 años (DE 18). La mayoría manifestaron fiebre, tos seca, disnea, febrícula y diarrea. Las comorbilidades más frecuentes fueron las enfermedades cardiovasculares, seguidas de las respiratorias y el cáncer. Las variables basales que se asociaron independientemente y de forma directa a peores resultados evolutivos (tanto a mortalidad como a evento combinado) fueron edad y obesidad; las variables clínicas fueron disminución de consciencia y crepitantes a la auscultación pulmonar, y de forma inversa cefalea; y las variables de resultados de exploraciones complementarias fueron infiltrados pulmonares bilaterales y cardiomegalia radiológicos, y linfopenia, hiperplaquetosis, dímero-D500 mg/dL y lactato-deshidrogenasa250 UI/L en la analítica.Conocer las características clínicas y la comorbilidad de los pacientes con COVID-19 atendidos en urgencias permite identificar precozmente a la población más susceptible de empeorar, para prever y mejorar los resultados.
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- 2020
45. Mitochondrial dysfunction: a common hallmark underlying comorbidity between sIBM and other degenerative and age-related diseases
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Pedro Juan Moreno-Lozano, Francesc Cardellach, Marc Catalán-García, Albert Lladó, Anna Novials, José C. Milisenda, Josep M. Grau-Junyent, Judith Cantó-Santos, Gema Alcarraz-Vizán, Francesc Josep García-García, Tamara Barcos-Rodríguez, Adrià Tort-Merino, and Glòria Garrabou
- Subjects
Apolipoprotein E ,medicine.medical_specialty ,sIBM 1 ,Alzheimer 2 ,T2DM 3 ,mitochondria 4 ,comorbidity 5 ,myositis 6 ,Amyloid beta ,medicine.medical_treatment ,lcsh:Medicine ,Comorbidity ,Polymyositis ,Article ,Mitocondris ,Inflammatory myopathy ,03 medical and health sciences ,0302 clinical medicine ,Comorbiditat ,Internal medicine ,Medicine ,Glucose homeostasis ,Myositis ,030304 developmental biology ,0303 health sciences ,biology ,business.industry ,Insulin ,lcsh:R ,General Medicine ,Dermatomyositis ,Alzheimer's disease ,medicine.disease ,Mitochondria ,Endocrinology ,Malaltia d'Alzheimer ,biology.protein ,business ,030217 neurology & neurosurgery - Abstract
Sporadic inclusion body myositis (sIBM) is an inflammatory myopathy associated, among others, with mitochondrial dysfunction. Similar molecular features are found in Alzheimer’s disease (AD) and Type 2 Diabetes Mellitus (T2DM), underlying potential comorbidity. This study aims to evaluate common clinical and molecular hallmarks among sIBM, AD, and T2DM. Comorbidity with AD was assessed in n = 14 sIBM patients by performing neuropsychological and cognitive tests, cranial magnetic resonance imaging, AD cerebrospinal fluid biomarkers (levels of amyloid beta, total tau, and phosphorylated tau at threonine-181), and genetic apolipoprotein E genotyping. In the same sIBM cohort, comorbidity with T2DM was assessed by collecting anthropometric measures and performing an oral glucose tolerance test and insulin determinations. Results were compared to the standard population and other myositis (n = 7 dermatomyositis and n = 7 polymyositis). Mitochondrial contribution into disease was tested by measurement of oxidative/anaerobic and oxidant/antioxidant balances, respiration fluxes, and enzymatic activities in sIBM fibroblasts subjected to different glucose levels. Comorbidity of sIBM with AD was not detected. Clinically, sIBM patients showed signs of misbalanced glucose homeostasis, similar to other myositis. Such misbalance was further confirmed at the molecular level by the metabolic inability of sIBM fibroblasts to adapt to different glucose conditions. Under the standard condition, sIBM fibroblasts showed decreased respiration (0.71 ± 0.08 vs. 1.06 ± 0.04 nmols O2/min; p = 0.024) and increased anaerobic metabolism (5.76 ± 0.52 vs. 3.79 ± 0.35 mM lactate; p = 0.052). Moreover, when glucose conditions were changed, sIBM fibroblasts presented decreased fold change in mitochondrial enzymatic activities (−12.13 ± 21.86 vs. 199.22 ± 62.52 cytochrome c oxidase/citrate synthase ratio; p = 0.017) and increased oxidative stress per mitochondrial activity (203.76 ± 82.77 vs. −69.55 ± 21.00; p = 0.047), underlying scarce metabolic plasticity. These findings do not demonstrate higher prevalence of AD in sIBM patients, but evidences of prediabetogenic conditions were found. Glucose deregulation in myositis suggests the contribution of lifestyle conditions, such as restricted mobility. Additionally, molecular evidences from sIBM fibroblasts confirm that mitochondrial dysfunction may play a role. Monitoring T2DM development and mitochondrial contribution to disease in myositis patients could set a path for novel therapeutic options.
- Published
- 2020
46. Causes, mortality rates and risk factors of death in community-dwelling Europeans aged 50 years and over: Results from the Survey of Health, Ageing and Retirement in Europe 2013-2015
- Author
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Laia Calvó-Perxas, Josep Garre-Olmo, Joan Vilalta-Franch, Secundino López-Pousa, Oriol Turró-Garriga, and Josep Lluís Conde-Sala
- Subjects
Male ,Aging ,Health (social science) ,Risk factors in diseases ,Population ,Comorbidity ,Símptomes ,Cohort Studies ,03 medical and health sciences ,0302 clinical medicine ,Comorbiditat ,Risk Factors ,Envelliment ,Surveys and Questionnaires ,Activities of Daily Living ,medicine ,Risk of mortality ,Mortalitat ,Humans ,030212 general & internal medicine ,Prospective Studies ,Depressió psíquica ,Mortality ,education ,Survey of Health, Ageing and Retirement in Europe ,Aged ,Proportional Hazards Models ,education.field_of_study ,Retirement ,030214 geriatrics ,Proportional hazards model ,business.industry ,Factors de risc en les malalties ,Mortality rate ,Hazard ratio ,Middle Aged ,medicine.disease ,Europe ,Mental depression ,Symptoms ,Independent Living ,Geriatrics and Gerontology ,business ,Gerontology ,Demography ,Cohort study - Abstract
Objective To determine mortality rates and to rank the causes and predictors of mortality using a wide range of sociodemographic and clinical variables. Materials and methods It is a prospective population-based cohort study of adults living in the community, 2013–15 N = 48,691, age ≥50; deceased = 1,944. Clinical and sociodemographic data were obtained from the Survey of Health, Ageing and Retirement in Europe SHARE: Age, Gender, Marital Status, Years of Schooling, Income, Loneliness, Cognition, Self-Rated Health, Diseases, Activities of daily living ADL, and Frailty. Mortality rates were calculated. A Cox proportional hazards model were used to determine risk-adjusted mortality ratios. Results The crude mortality rate was 18.39 (1000 person-years at risk), (99 % CI, 18.37–18.42). The factors most associated with an increased mortality risk were older age, lower self-rated health, lower cognition, male gender, ADL deficits, higher comorbidity, frailty and loneliness. The diseases with a higher mortality risk were: cancer (Hazard ratio, HR = 2.67), dementia (HR = 2.19), depressive symptoms (HR = 2.10), fractures (hip, femur) (HR = 1.57), stroke (HR = 1.55), chronic lung disease (HR = 1.52), diabetes (HR = 1.36) and heart attack (HR = 1.21). Conclusions The main mortality risk factors, associated independently in the eight diseases were: older age, poor self-rated health, ADL deficits, male gender, lower cognition, comorbidity and the presence of depressive symptoms, with a different influence in the European regions. The need to evaluate and treat the depressive symptoms that accompanies diseases with higher risk of mortality is stressed.
- Published
- 2020
47. Spanish Validation of the 'User Reported Measure of Care Coordination' Questionnaire for Older People with Complex, Chronic Conditions
- Author
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Adelaida Zabalegui, Ester Risco, Núria Fabrellas, Nihan Acar-Denizli, Albert Alonso, Belchin Kostov, Paloma Amil, Ana Paola Ríos, Jaume Martín, Anna Albero, and Gloria Saüch
- Subjects
Male ,Intraclass correlation ,Health, Toxicology and Mutagenesis ,lcsh:Medicine ,Old age assistance ,Comorbidity ,Care provision ,Persones grans ,older people ,0302 clinical medicine ,Surveys and Questionnaires ,Health care ,030212 general & internal medicine ,integrated care ,Aged, 80 and over ,Chronic care ,Public health ,030503 health policy & services ,health care ,Test (assessment) ,comorbidity ,Female ,0305 other medical science ,Psychology ,medicine.medical_specialty ,Psychometrics ,Article ,03 medical and health sciences ,Cronbach's alpha ,Comorbiditat ,medicine ,Humans ,Translations ,Patient Reported Outcome Measures ,person centered care ,Aged ,business.industry ,lcsh:R ,Public Health, Environmental and Occupational Health ,Reproducibility of Results ,Assistència a les persones grans ,medicine.disease ,social care ,Salut pública ,Integrated care ,Family medicine ,Chronic Disease ,Older people ,business - Abstract
Introduction: Older people with complex, chronic conditions often receive insufficient or inefficient care provision, and few instruments are able to measure their perception of care provision. The &ldquo, User Reported Measure of Care Coordination&rdquo, instrument has been satisfactorily used to evaluate chronic care provision and integration. The aim of this study is to validate this instrument in Spanish. Methods: The questionnaire was adapted and validated in two phases: translation and cultural adaptation of the questionnaire and psychometric property measurement. Study population were chronic care conditions patients. Results: A total of 332 participants completed test re-test as part of the questionnaire validation process. The final version of the questionnaire had 6 domains: Health and Well-being (D1), Health day to day (D2), Social Services (D3), Planned Care (D4), Urgent Care (D5), and Hospital Care (D6). Cronbach&rsquo, s alpha for the overall questionnaire was 0.86, indicating good internal consistency. When analyzing each domain, only Planned Care (D4) and Urgent Care (D5) had Cronbach&rsquo, s Alphas slightly lower than 0.7, although this could be related to the low number of items in each domain. A good temporal stability was observed for the distinct subscales and items, with intraclass correlation coefficients varying from 0.412 to 0.929 (p <, 0.05). Conclusion: The adapted version of the &ldquo, into Spanish proved to be a practical tool for use in our daily practice and an efficient instrument for assessment of care coordination in chronic, complex conditions in older people across services and levels of care.
- Published
- 2020
48. Central sensitization: a pathogenic mechanism in complex undefined diseases
- Author
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Fernández-Solà, J. (Joaquim)
- Subjects
Sentits ,Senses ,Comorbiditat ,Neurofisiologia ,Neurophysiology ,Comorbidity - Abstract
There is a common perception that complex undefined diseases manifested with diverse combination of symptoms and a difficult clinical diagnosis have a possible common physiological mechanism of disease production. Physical or cognitive fatigue, widespread pain without arthritis, sleep, mood and autonomic disturbances as well as multiple intolerance involving drug, food, chemical agents, electromagnetic fields or other environmental factors may be included in this category. Along last three decades, the existence of central sensitivity as a well established common pathogenic mechanism involved in abnormal symptom development emerged in diverse areas as pain, fatigue, food and environmental intolerance, as well as in the global chronic disease epidemic. The common fact of all of these disorders is a deregulation of the central control mechanisms at the limbic brain system. This may relate to amplification of pain and fatigue perception and disturbance of environmental tolerance and control of circadian rhythms and mood. This deregulation causes amplification of central somatosensory perception, but also a decrease of nociceptive inhibitory outputs. The final result is a chronic condition with central hyperexcitability and systemic disabling symptoms highly difficult to manage. This article comments on the current significance to evaluate central sensitization symptoms and to consider these mechanisms in the development of complex diseases, as well as in the global chronic disease epidemic. We propose to include central sensitization to structuring a multidisciplinary concept addressed to improve scientific comprehension and clinical management of these diseases, as wee as future research directions on this field.
- Published
- 2019
49. Ability to Monitor National Responses to the HIV Epidemic 'Beyond Viral Suppression': Findings From Six European Countries
- Author
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Kelly Safreed-Harmon, Meaghan Kall, Jane Anderson, Natasha Azzopardi-Muscat, Georg M. N. Behrens, Antonella d'Arminio Monforte, Udi Davidovich, Teymur Noori, and Jeffrey V. Lazarus
- Subjects
Estonia ,Turkey ,media_common.quotation_subject ,Slovenia ,Fertility ,HIV Infections ,Comorbidity ,Disease ,Health informatics ,Nonprobability sampling ,03 medical and health sciences ,0302 clinical medicine ,Quality of life (healthcare) ,Comorbiditat ,Environmental health ,VIH (Virus) ,Medicine ,Humans ,030212 general & internal medicine ,Epidemics ,media_common ,Netherlands ,Original Research ,Sweden ,HIV (Viruses) ,business.industry ,030503 health policy & services ,lcsh:Public aspects of medicine ,indicator ,Public Health, Environmental and Occupational Health ,HIV ,lcsh:RA1-1270 ,medicine.disease ,Mental health ,Europe ,health-related quality of life ,comorbidity ,monitoring ,Italy ,Quality of Life ,Public Health ,Europa ,0305 other medical science ,business ,Psychosocial - Abstract
With more people living with HIV (PLHIV) ageing into their 50s and beyond in settings where antiretroviral therapy is widely available, non-AIDS comorbidities and health-related quality of life (HRQoL) are becoming major challenges. Information is needed about whether national HIV monitoring programmes have evolved to reflect the changing focus of HIV care. " - " We created a 56-item English-language survey to assess whether health systems report on common health-related issues for people with HIV including physical and mental health comorbidities, HRQoL, psychosocial needs, and fertility desires. One expert was identified via purposive sampling in each of six countries (Estonia, Italy, the Netherlands, Slovenia, Sweden, and Turkey) and was asked to participate in the survey. " - " Three respondents reported that the current monitoring systems in their countries do not monitor any of four specified aspects of 10 comorbidities including bone loss, cardiovascular disease, and neurocognitive disorders. Two respondents stated that their countries potentially can report on leading causes of hospital admission among PLHIV, and five on leading cases of death. In three countries, respondents reported that there was the ability to report on the HRQoL of PLHIV. In two countries, respondents provided data on the percentage of PLHIV denied health services because of HIV status in the past 12 months. " - " This study identified areas for potential HIV monitoring improvements in six European countries in relation to comorbidities, HRQoL, discrimination within health systems, and other issues associated with the changing nature of the HIV epidemic. It also indicated that some countries either currently monitor or have the ability to monitor some of these issues. There are opportunities for health information systems in European countries to expand the scope of their HIV monitoring in order to support decision-making about how the long-term health-related needs of PLHIV can best be met.
- Published
- 2019
50. The association between Internet Gaming Disorder or pathological videogame use and comorbid psychopathology: a comprehensive review
- Author
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Universitat Politècnica de Catalunya. Departament d'Estadística i Investigació Operativa, Universitat Politècnica de Catalunya. GRBIO - Grup de Recerca en Bioestadística i Bioinformàtica, González Bueso, Vega, Santamaría, Juan José, Fernández Martínez, Daniel, Merino Gómez, Laura, Montero, Elena, Ribas, Joan, Universitat Politècnica de Catalunya. Departament d'Estadística i Investigació Operativa, Universitat Politècnica de Catalunya. GRBIO - Grup de Recerca en Bioestadística i Bioinformàtica, González Bueso, Vega, Santamaría, Juan José, Fernández Martínez, Daniel, Merino Gómez, Laura, Montero, Elena, and Ribas, Joan
- Abstract
The addictive use of video games is recognized as a problem with clinical relevance and is included in international diagnostic manuals and classifications of diseases. The association between “Internet addiction” and mental health has been well documented across a range of investigations. However, a major drawback of these studies is that no controls have been placed on the type of Internet use investigated. The aim of this study is to review systematically the current literature in order to explore the association between Internet Gaming Disorder (IGD) and psychopathology. An electronic literature search was conducted using PubMed, PsychINFO, ScienceDirect, Web of Science and Google Scholar (r.n. CRD42018082398). The effect sizes for the observed correlations were identified or computed. Twenty-four articles met the eligibility criteria. The studies included comprised 21 cross-sectional and three prospective designs. Most of the research was conducted in Europe. The significant correlations reported comprised: 92% between IGD and anxiety, 89% with depression, 85% with symptoms of attention deficit hyperactivity disorder (ADHD), and 75% with social phobia/anxiety and obsessive-compulsive symptoms. Most of the studies reported higher rates of IGD in males. The lack of longitudinal studies and the contradictory results obtained prevent detection of the directionality of the associations and, furthermore, show the complex relationship between both phenomena., Peer Reviewed, Postprint (published version)
- Published
- 2019
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